Effect of phenylephrine versus norepinephrine on 28-day mortality and SICU length of stay in septic shock. Issue 4 (11th July 2020)

• Record Type: Journal Article
• Authors: Santoriello, Lisa; Schweiger, Krislyn; Aronowitz, Danielle; Maisch, Nicole; Smith, Candace; Wu, Wenchen; Patel, Vihas; Coppa, Gene; Barrera, Rafael
• Is Part Of: International journal of surgery global health. Volume 3:Issue 4(2020)
• Page Start: e19
• Page End: e19
• Publication Date: 2020-07-11
• Subjects: Critical care -- Sepsis -- Vasopressors
• DOI: 10.1097/GH9.0000000000000019
• Languages: English
• ISSNs: 2576-3342

Abstract

Abstract : Background: According to the Surviving Sepsis Campaign (SSC) guidelines, norepinephrine is the preferred vasopressor over phenylephrine when treating hemodynamically unstable septic patients. However, few studies have directly compared the use of these 2 vasopressors in septic shock patients. Objective: To compare 28-day mortality and surgical intensive care unit (SICU) length of stay in septic shock patients treated with phenylephrine and norepinephrine. Methods: Retrospective chart review of septic shock patients admitted from January 2012 through June 2017, who were treated with either phenylephrine or norepinephrine. The primary endpoint was assessment of 28-day mortality, secondary endpoint was SICU length of stay. The same endpoints were also evaluated specifically in patients with known cardiac disease. Results: Of the 30 patients included, 15 had been treated with norepinephrine and 15 with phenylephrine. Patients in either group had similar demographics and SOFA scores. No statistically significant difference was observed in either 28-day mortality (P=0.200) or SICU length of stay (P=0.544) between the 2 vasopressor groups. There was still no significant difference in the primary or secondary endpoints when compared among patients with baseline cardiac disease. Conclusion: Phenylephrine use in patients with septic shock does not appear to increase risk of 28-day mortality or prolong SICU length of stay when compared with using norepinephrine. However, its use also does not improve outcomes, even in patients with significant cardiac history.