Vasoactive Drugs in Intensive Care Unit
Sponsored by University of Chicago
About this study
The investigators hypothesis is that for ICU patients with shock, the use of the vasoactive drugs phenylephrine and vasopressin will reduce tachydysrhythmias when compared to norepinephrine and epinephrine. To investigate this hypothesis, the investigators are conducting a randomized double blind controlled trial comparing phenylephrine and vasopressin vs. norepinephrine and epinephrine in ICU patients with shock that is not responsive to IV fluids. All patients admitted to the adult intensive care units at the University of Chicago will be screened for eligibility.
Shock, defined by inadequate tissue perfusion, is a common problem in critically ill patients. Most patients who have shock have hypotension and this is typically treated initially with intravenous fluid resuscitation in patients who are fluid responsive. If patients remain hypotensive, they are typically treated with vasoactive medications. Four of the commonly used FDA approved vasoactive medications are norepinephrine, phenylephrine, epinephrine, and vasopressin. Apart from a 2010 trial comparing norepinephrine to dopamine, there are no studies to date that have shown one of the four above-mentioned vasoactive medications to be superior to another. Accordingly, choice of vasoactive medication is based upon individual physician preference, without an outcomes-related evidence base. Two …
Where this study is enrolling
- I'm interested
University of Chicago Medical Center
Chicago, Illinois
Who can participate
Inclusion criteria
- ✓1. Age greater than or equal to 18 years old
- ✓2. Requirement for vasoactive drugs via a central venous catheter for the treatment of shock. Shock will be defined as mean arterial pressure less than 70 mmHg or systolic blood pressure less than 100 mmHg despite administration of at least 1000 mL of crystalloid or 500 mL of colloid, unless there is an elevation in the central venous pressure to \> 12 mmHg or in the pulmonary artery occlusion pressure to \> 14 mmHg coupled with signs of tissue hypoperfusion (e.g. altered mental state, mottled skin, urine output \< 0.5 mL/kg body weight for one hour, or a serum lactate level of \> 2 mmol per liter).
Exclusion criteria
- ✕1. Cardiopulmonary arrest
- ✕2. Pregnancy
- ✕3. Severe right heart failure
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Trial data sourced from ClinicalTrials.gov.