• Sarah Singer, Hannah Pope, Brian M Fuller, and Gabrielle Gibson.
• Barnes-Jewish Hospital, 1 Barnes Jewish Hospital Plaza, St. Louis, MO 63110, United States of America. Electronic address: sarah.singer@bjc.org.
• Am J Emerg Med. 2022 Nov 1; 61: 137142137-142.

PurposeTo evaluate practice patterns, efficacy, and safety of push dose pressors (PDP) in critically ill patients outside of the operating room (OR) at a large academic medical center.Materials And MethodsThis was a single-center, retrospective cohort study (June 2018 to July 2020) conducted at a 1273-bed academic medical center. The primary outcome was efficacy, defined as a 25% increase in systolic blood pressure, and the cohort was analyzed according to PDP response (i.e. responders versus non-responders). A logistic regression model was used to assess predictors of response to PDPs. Safety outcomes included the incidence of hypertension, bradycardia, and tachycardia.Results1727 patients were included in the final analysis. The median doses of phenylephrine and epinephrine administered were 400 μg (IQR 200-888 μg) and 50 μg (IQR 20-100 μg). The primary outcome was achieved in 102 (71.8%) patients in the epinephrine group and 1140 (55.9%) of patients in the phenylephrine group. Adverse effects after PDP receipt were minimal, with the most common being hypertension in 6.6% and 13.4% of the phenylephrine and epinephrine groups respectively.ConclusionsThis study demonstrates that PDP phenylephrine and epinephrine are safe and efficacious in treating the acute hypotensive period.Copyright © 2022 Elsevier Inc. All rights reserved.

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