Norepinephrine and Hospital Mortality in Critically Ill Patients Undergoing Continuous Renal Replacement Therapy

• Published in: Artificial organs 2011-02, Vol.35 (2), p.E11-E17
• Main Authors: Chou, Che-Yi, Yeh, Hung-Chieh, Chen, Wei, Liu, Jiung-Hsiun, Lin, Hsin-Hung, Liu, Yao-Lung, Yang, Ya-Fei, Wang, Shu-Ming, Huang, Chiu-Ching
• Format: Article
• Language: English
• Subjects: Acute kidney injury; Aged; Aged, 80 and over; APACHE; Catecholamines; Catecholamines - therapeutic use; Continuous renal replacement therapy; Critical Illness - mortality; Dopamine; Dopamine - therapeutic use; Female; Hemodiafiltration; Hemofiltration; Hospital Mortality; Humans; Intensive care unit; Kaplan-Meier Estimate; Male; Middle Aged; Mortality; Norepinephrine; Norepinephrine - therapeutic use; Renal Replacement Therapy - mortality; Retrospective Studies; Vasoconstrictor Agents - therapeutic use; Vasopressor
• ISSN: 0160-564X; 1525-1594
• DOI: 10.1111/j.1525-1594.2010.01115.x

High‐dose vasopressor use is associated with increasing mortality in patients with septic shock. We conducted this study to determine if the high‐dose of vasopressor used before the initiation of continuous renal replacement therapy (CRRT) is associated with increasing mortality in critically ill patients. We retrospectively reviewed all patients who underwent CRRT in the medical intensive care unit of China Medical University Hospital between 2003 and 2007. The association between mortality and highest vasopressors (dopamine and norepinephrine [NE]) dose used were analyzed using Kaplan–Meier analysis and multivariate Cox regression. A total of 279 patients (170 men and 109 women) treated with CRRT in medical intensive care were reviewed and 237 (84.9%) died. In Kaplan–Meier analysis with log‐rank test, dopamine dose of ≥20 µg/kg/min and NE dose of ≥0.3 µg/kg/min were significantly linked to mortality (P = 0.007 and