A prospective and observational study on rationale use of noradrenalin and vasopressin in critically ill patients

Abstract

Background: Shock, particularly septic shock, is a critical medical condition characterized by inadequate blood flow, leading to multi-organ failure and high mortality rates. Traditional treatment includes fluid resuscitation and antibiotic therapy, but advancements in understanding and management are needed. This study aims to evaluate the rationale use of noradrenalin and vasopressin in patients with shock, specifically focusing on their effects on blood pressure.

Methods: Conducted as a prospective observational study at a tertiary care hospital, the study involved 50 critically ill patients diagnosed with septic, cardiogenic or hypovolemic shock. Patients were treated with either noradrenalin, vasopressin or both and data were collected from ICU, HICU and CCU admissions. Inclusive criteria included critically ill patients with shock on noradrenalin or vasopressin. Exclusion criteria included pregnant or breastfeeding women and dialysis patients.

Results: Among the patients, septic shock was the most common type (68%). Age distribution showed a majority (24%) aged 61-70 years, while a minority (2%) was 11-20 years old. Significant contributors to septic shock were lower respiratory tract infections (23.4%) and urosepsis (19.4%). The study noted fluctuations in systolic and diastolic blood pressures in response to the medications.

Conclusions: The study result demonstrated that the change in the blood pressure were significant. Changes in the diastolic pressure when used vasopressin along with norepinephrine was more prominent. Drug interactions didn’t cause any adverse effects in the course of treatment as there is no significant fluctuation in the K levels. Not much difference was seen in blood cells count, ABG but significant decrease in serum lactate, CRP and troponin were seen.