Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34943
Title: Dose equivalence for metaraminol and noradrenaline - A retrospective analysis.
Austin Authors: Costa-Pinto, Rahul;Neto, Ary Serpa;Matthewman, Madeline Coxwell;Osrin, Dean;Liskaser, Grace;Li, Jasun ;Young, Marcus ;Jones, Daryl A ;Udy, Andrew;Warrillow, Stephen J ;Bellomo, Rinaldo 
Affiliation: Intensive Care
Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Data Analytics Research and Evaluation (DARE) Centre
Department of Critical Care, Department of Medicine, the University of Melbourne, Parkville, Victoria, Australia; Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Intensive Care, The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Data Analytics Research and Evaluation Centre, The University of Melbourne and Austin Hospital, Melbourne, Australia; Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Issue Date: Apr-2024
Publication information: Journal of Critical Care 2024-04; 80
Abstract: Noradrenaline and metaraminol are commonly used vasopressors in critically ill patients. However, little is known of their dose equivalence. We conducted a single centre retrospective cohort study of all ICU patients who transitioned from metaraminol to noradrenaline infusions between August 26, 2016 and December 31, 2020. Patients receiving additional vasoactive drug infusion were excluded. Dose equivalence was calculated based on the last hour metaraminol dose (in μg/min) and the first hour noradrenaline dose (in μg/min) with the closest matched mean arterial pressure (MAP). Sensitivity analyses were performed on patients with acute kidney injury (AKI), sepsis and mechanical ventilation. We studied 195 patients. The median conversion ratio of metaraminol to noradrenaline was 12.5:1 (IQR 7.5-20.0) for the overall cohort. However, the coefficient of variation was 77% and standard deviation was 11.8. Conversion ratios were unaffected by sepsis or mechanical ventilation but increased (14:1) with AKI. One in five patients had a MAP decrease of >10 mmHg during the transition period from metaraminol to noradrenaline. Post-transition noradrenaline dose (p < 0.001) and AKI (p = 0.045) were independently associated with metaraminol dose. The proportion of variation in noradrenaline dose predicted from metaraminol dose was low (R2 = 0.545). The median dose equivalence for metaraminol and noradrenaline in this study was 12.5:1. However, there was significant variance in dose equivalence, only half the proportion of variation in noradrenaline infusion dose was predicted by metaraminol dose, and conversion-associated hypotension was common.
URI: https://ahro.austin.org.au/austinjspui/handle/1/34943
DOI: 10.1016/j.jcrc.2023.154430
ORCID: 
Journal: Journal of Critical Care
Start page: 154430
PubMed URL: 38245376
ISSN: 1557-8615
Type: Journal Article
Subjects: Acute kidney injury
Dose equivalence
Metaraminol
Noradrenaline
Sepsis
Vasodilatory shock
Sepsis/complications
Acute Kidney Injury/complications
Appears in Collections:Journal articles

Show full item record

Page view(s)

10
checked on Apr 12, 2024

Google ScholarTM

Check


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.