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dc.contributor.authorKusakabe, Ayano
dc.contributor.authorSweeny, Amy
dc.contributor.authorKeijzers, Gerben
dc.contributor.authorSteering Committee of the ARISE FLUIDS observational study group (see acknowledgement)
dc.date.accessioned2021-07-29T04:23:01Z
dc.date.available2021-07-29T04:23:01Z
dc.date.issued2021
dc.identifier.issn0188-4409
dc.identifier.doi10.1016/j.arcmed.2021.07.001
dc.identifier.urihttp://hdl.handle.net/10072/406470
dc.description.abstractAIM: To describe and compare early with late vasopressor commencement in emergency department (ED) patients with sepsis and hypotension. METHODS: This is a sub-study of the ARISE FLUIDS observational study conducted in 70 EDs in Australia and New Zealand. Adults with suspected sepsis and hypotension who received a vasopressor infusion in the first 24 h after ED presentation were included. 'Early' was defined as vasopressor commenced within 2 h from a) sepsis recognition, or b) triage. RESULTS: 177 patients (mean age 68 years) received vasopressors and had a lactate of 3.0 (IQR 2.0-4.9) mmol/L and APACHE II score of 17.8 (SD 6.3). 110 (62%) received a single agent vasopressor with noradrenaline being the most common (n = 74) and 67 (38%) received multiple vasopressors, most commonly metaraminol then noradrenaline (20.3%, n = 36). One-third (34.7%, n = 62) had vasopressors started via a peripheral line. Vasopressors were started within 2 h of sepsis recognition in 74 patients and within 2 h of triage in 24 patients. Both early groups had a higher lactate (3.5 vs. 2.9mmol/L and 5.0 vs. 2.9mmol/L, both p <0.05) and received lower fluid volumes prior to vasopressor commencement (2.0 vs. 2.85 L and 1.55 vs. 2.4 L, both p <0.001), compared to patients receiving vasopressors later. No differences in duration of vasopressor infusion, need for organ support or in-hospital mortality were found. CONCLUSION: Early vasopressor commencement was associated with the administration of lower intravenous fluid volumes but not with duration of vasopressor use, organ support or mortality. Large prospective studies addressing this question are required.
dc.description.peerreviewedYes
dc.languageeng
dc.publisherElsevier BV
dc.relation.ispartofjournalArchives of Medical Research
dc.subject.fieldofresearchBiomedical and clinical sciences
dc.subject.fieldofresearchcode32
dc.subject.keywordsEmergency department
dc.subject.keywordsResuscitation
dc.subject.keywordsSepsis
dc.subject.keywordsVasopressors
dc.titleEarly compared to later commencement of vasopressors in the management of Emergency Department patients with sepsis and hypotension, a multi-centre observational study
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationKusakabe, A; Sweeny, A; Keijzers, G; Steering Committee of the ARISE FLUIDS observational study group (see acknowledgement), , Early compared to later commencement of vasopressors in the management of Emergency Department patients with sepsis and hypotension, a multi-centre observational study, Archives of Medical Research, 2021
dcterms.dateAccepted2021-07-01
dc.date.updated2021-07-27T23:48:21Z
gro.description.notepublicThis publication has been entered as an advanced online version in Griffith Research Online.
gro.hasfulltextNo Full Text
gro.griffith.authorKeijzers, Gerben
gro.griffith.authorSweeny, Amy L.


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