| Title |
Automatic versus manual changeovers of norepinephrine infusion pumps in critically ill adults: a prospective controlled study
|
|---|---|
| Published in |
Annals of Intensive Care, November 2015
|
| DOI | 10.1186/s13613-015-0083-7 |
| Pubmed ID | |
| Authors |
Emilie Greau, Jean-Baptiste Lascarrou, Aurélie Le Thuaut, Nathalie Maquigneau, Yolaine Alcourt, Anne Coutolleau, Cécile Rousseau, Vanessa Erragne, Jean Reignier |
| Abstract |
Norepinephrine is a key drug for treating shock but has a short half-life that requires continuous intravenous administration to maintain the constant plasma concentration needed to obtain a stable blood pressure. The small volume of the syringes used in power infusion pumps requires frequent changeovers, which can lead to norepinephrine flow interruptions responsible for hemodynamic instability. Changeovers from the nearly empty to the full syringe can be performed manually using the quick change technique (QC) or automatically using smart infusion pumps (SIP) that link two syringes. The purpose of our study was to evaluate the hypothesis that, compared to QC, SIP for norepinephrine changeovers was associated with less hemodynamic instability. After information of the patient or next of kin, patients receiving norepinephrine for shock were allocated to QC or SIP changeovers. QC changeovers were performed by a nurse, who started a new loaded pump when the previous syringe was nearly empty. SIP changeovers were managed automatically by SIP workstations. The primary outcome was the proportion of changeovers followed by a ≥20 % drop in mean arterial pressure (MAP). 411 changeovers were performed, 193 in the 18 patients allocated to QC and 218 in the 32 patients allocated to SIP. Baseline patient characteristics were similar in both groups. The proportion of changeovers followed by an MAP drop ≥20 % was 12.4 % (24/193) with QC and 5.5 % (12/218) with SIP (P = 0.01). By multivariate analysis, two factors were independently associated with a significantly decreased risk of ≥20 % MAP drops during changeovers, namely, SIP (odds ratio, 0.47; 95 % confidence interval, 0.22-0.98) and norepinephrine dosage >0.5 μg/kg/min (odds ratio, 0.39; 95 % confidence interval, 0.19-0.81). The risk of MAP drops ≥20 % during changeovers can be significantly diminished using SIPs instead of the QC method. Clinicaltrial.gov NCT 01127152. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| France | 1 | 50% |
| Unknown | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 37 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 3% |
| Unknown | 36 | 97% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 4 | 11% |
| Other | 4 | 11% |
| Student > Bachelor | 3 | 8% |
| Student > Master | 3 | 8% |
| Lecturer | 1 | 3% |
| Other | 4 | 11% |
| Unknown | 18 | 49% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 7 | 19% |
| Nursing and Health Professions | 5 | 14% |
| Engineering | 2 | 5% |
| Unspecified | 1 | 3% |
| Unknown | 22 | 59% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 April 2019.
All research outputs
#15,350,522
of 22,833,393 outputs
Outputs from Annals of Intensive Care
#827
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#164,231
of 281,503 outputs
Outputs of similar age from Annals of Intensive Care
#18
of 27 outputs
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