TY - JOUR
T1 - Vasopressor dose equivalence
T2 - A scoping review and suggested formula
AU - Goradia, Shruti
AU - Sardaneh, Arwa Abu
AU - Narayan, Sujita W.
AU - Penm, Jonathan
AU - Patanwala, Asad E.
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/2
Y1 - 2021/2
N2 - Purpose: Calculating equipotent doses between vasopressor agents is necessary in clinical practice and research pertaining to the management of shock. This scoping review summarizes conversion ratios between vasopressors and provides a formula to incorporate into study designs. Materials and methods: Medline, Embase and Web of Science databases were searched from inception to 21st October 2020. Additional papers were obtained through bibliography searches of retrieved articles. Two investigators assessed articles for eligibility. Clinical trials comparing the potency of at least two intravenous vasopressors (norepinephrine, epinephrine, dopamine, phenylephrine, vasopressin, metaraminol or angiotensin II), with regard to an outcome of blood pressure, were selected. Results: Of 16,315 articles, 21 were included for synthesis. The range of conversion ratios equivalent to one unit of norepinephrine were: epinephrine (0.7–1.4), dopamine (75.2–144.4), metaraminol (8.3), phenylephrine (1.1–16.3), vasopressin (0.3–0.4) and angiotensin II (0.07–0.13). The following formula may be considered for the calculation of norepinephrine equivalents (NE) (all in mcg/kg/min, except vasopressin in units/min): NE = norepinephrine + epinephrine + phenylephrine/10 + dopamine/100 + metaraminol/8 + vasopressin*2.5 + angiotensin II*10. Conclusion: A summary of equipotent ratios for common vasopressors used in clinical practice has been provided. Our formula may be considered to calculate NE for studies in the intensive care unit.
AB - Purpose: Calculating equipotent doses between vasopressor agents is necessary in clinical practice and research pertaining to the management of shock. This scoping review summarizes conversion ratios between vasopressors and provides a formula to incorporate into study designs. Materials and methods: Medline, Embase and Web of Science databases were searched from inception to 21st October 2020. Additional papers were obtained through bibliography searches of retrieved articles. Two investigators assessed articles for eligibility. Clinical trials comparing the potency of at least two intravenous vasopressors (norepinephrine, epinephrine, dopamine, phenylephrine, vasopressin, metaraminol or angiotensin II), with regard to an outcome of blood pressure, were selected. Results: Of 16,315 articles, 21 were included for synthesis. The range of conversion ratios equivalent to one unit of norepinephrine were: epinephrine (0.7–1.4), dopamine (75.2–144.4), metaraminol (8.3), phenylephrine (1.1–16.3), vasopressin (0.3–0.4) and angiotensin II (0.07–0.13). The following formula may be considered for the calculation of norepinephrine equivalents (NE) (all in mcg/kg/min, except vasopressin in units/min): NE = norepinephrine + epinephrine + phenylephrine/10 + dopamine/100 + metaraminol/8 + vasopressin*2.5 + angiotensin II*10. Conclusion: A summary of equipotent ratios for common vasopressors used in clinical practice has been provided. Our formula may be considered to calculate NE for studies in the intensive care unit.
KW - Blood pressure
KW - Clinical trials
KW - Intensive care
KW - Scoping review
KW - Shock
KW - Vasopressor
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U2 - 10.1016/j.jcrc.2020.11.002
DO - 10.1016/j.jcrc.2020.11.002
M3 - Review article
C2 - 33220576
AN - SCOPUS:85096198837
SN - 0883-9441
VL - 61
SP - 233
EP - 240
JO - Journal of Critical Care
JF - Journal of Critical Care
ER -