• Journal of critical care · Feb 2022

    Monitoring, management, and outcome of hypotension in Intensive Care Unit patients, an international survey of the European Society of Intensive Care Medicine.

    • W H van der Ven, J Schuurmans, J Schenk, S Roerhorst, CherpanathT G VTGVAmsterdam UMC, University of Amsterdam, Department of Intensive Care, Meibergdreef 9, Amsterdam, Netherlands., W K Lagrand, P Thoral, ElbersP W GPWGAmsterdam UMC, Vrije Universiteit Amsterdam, Department of Intensive Care, Laboratory for Critical Care Computational Intelligence, Amsterdam Medical Data Science, Amsterdam Cardiovascular Science, Amsterdam Infection and Immunity, De Boelel, P R Tuinman, ScheerenT W LTWLUniversity Medical Center Groningen, University of Groningen, Department of Anesthesiology, Groningen, Netherlands., J Bakker, B F Geerts, D P Veelo, F Paulus, VlaarA P JAPJAmsterdam UMC, University of Amsterdam, Department of Intensive Care, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam UMC, University of Amsterdam, Laboratory of Experimental Intensive Care and Anesthesiology, Meibergdreef 9, Amsterdam, Net, and Cardiovascular Dynamics Section of the ESICM.
    • Amsterdam UMC, University of Amsterdam, Department of Anesthesiology, Meibergdreef 9, Amsterdam, Netherlands.
    • J Crit Care. 2022 Feb 1; 67: 118-125.

    IntroductionHypotension in the ICU is common, yet management is challenging and variable. Insight in management by ICU physicians and nurses may improve patient care and guide future hypotension treatment trials and guidelines.MethodsWe conducted an international survey among ICU personnel to provide insight in monitoring, management, and perceived consequences of hypotension.ResultsOut of 1464 respondents, 1197 (81.7%) were included (928 physicians (77.5%) and 269 nurses (22.5%)). The majority indicated that hypotension is underdiagnosed (55.4%) and largely preventable (58.8%). Nurses are primarily in charge of monitoring changes in blood pressure, physicians are in charge of hypotension treatment. Balanced crystalloids, dobutamine, norepinephrine, and Trendelenburg position were the most frequently reported fluid, inotrope, vasopressor, and positional maneuver used to treat hypotension. Reported complications believed to be related to hypotension were AKI and myocardial injury. Most ICUs do not have a specific hypotension treatment guideline or protocol (70.6%), but the majority would like to have one in the future (58.1%).ConclusionsBoth physicians and nurses report that hypotension in ICU patients is underdiagnosed, preventable, and believe that hypotension influences morbidity. Hypotension management is generally not protocolized, but the majority of respondents would like to have a specific hypotension management protocol.Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.

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