Abstract
Objective
Use of vasoactive medications is common in pediatric intensive care units (ICUs), however evidence to guide medication selection is limited likely resulting in practice variation. Our objective was to describe the use of vasoactive infusions across ICUs and sites.
Design
Retrospective cohort study using the multi-institutional PICU Data Collaborative (PDC) database.
Setting
Four pediatric ICUs (PICUs) and three cardiac ICUs (CICUs) from the U.S. participating in the PDC.
Patients
Patients admitted to a participating ICU between 2010 and 2022 who received a vasoactive infusion within 7 days of ICU admission.
Interventions
None.
Measurements and Main Results
A vasoactive infusion was administered within the first 7 days of admission in 16,959 (22%) out of a total of 75,953 ICU encounters. CICU encounters comprised 20% of all ICU encounters but 60% of those with a vasoactive infusion. The most frequently used vasoactive medications were milrinone (63%) and epinephrine (59%). We found a statistically significant difference in the frequency of each vasoactive infusion between PICU sites (P < 0.001) and between CICU sites (P < 0.001). The median peak vasoactive inotrope score (VIS) was 10 [IQR 5.5–20] and 8 [IQR 5–12.5] among PICU and CICU encounters respectively.
Conclusions
We found significant variability in the frequency of vasoactive infusion medication use between sites and type of ICU. Further investigation is needed to understand what impact this practice variability has on patient outcomes.
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References
Supplementary Material
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