title: Vasopressor administration and sepsis: a survey of Canadian intensivists.
abstract: BACKGROUND
  Patients with septic shock often receive intravenous vasopressor infusions, with little evidence available to guide their titration. We surveyed Canadian intensivists to document self-reported vasopressor titration strategies for patients with septic shock.
  
  
  METHODS
  We identified Canadian intensivists caring for adult patients by merging membership lists of 3 Canadian critical care associations. We invited respondents to complete a scenario-based questionnaire to understand triggers for vasopressor use, target blood pressure values, and the influence of chronic comorbidities and acute illnesses on vasopressor prescription.
  
  
  RESULTS
  Sixty-three percent of eligible intensivists completed our survey. Most respondents (82.6%) would frequently or always administer vasopressor therapy for isolated hypotension but not for other isolated signs of organ failure (such as elevated serum lactate or low urine output). Respondents defined low blood pressure using mean arterial pressure (83.7%) and aimed for higher values when resuscitating a patient with multiple organ failure. Chronic comorbidities and acute concurrent illnesses had variable effects on stated vasopressor prescription. Norepinephrine (94.8%) was the preferred first-line vasopressor.
  
  
  CONCLUSIONS
  Self-reported vasopressor use for the treatment of septic shock is relatively uniform among Canadian intensivists; however, practice is variable in patients with chronic comorbidities or acute concurrent illnesses.
authors: Centre de Recherche Clinique Étienne-Le Bel and Department of Medicine, Université de Sherbrooke, Sherbrooke, Canada. Electronic address: francois.lamontagne@uherbrooke.ca.
authors: Francois
authors: F
authors: Lamontagne
authors: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada; Department of Medicine, McMaster University, Hamilton, Canada.
authors: Deborah J
authors: DJ
authors: Cook
authors: Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
authors: Neill K J
authors: NKJ
authors: Adhikari
authors: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada; Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland.
authors: Matthias
authors: M
authors: Briel
authors: Department of Pediatrics, McMaster University, Hamilton, Canada.
authors: Mark
authors: M
authors: Duffett
authors: Department of Physical Medicine & Rehabilitation, Johns Hopkins University, Baltimore.
authors: Michelle E
authors: ME
authors: Kho
authors: Department of Critical Care, St Michael's Hospital, Toronto, Canada.
authors: Karen E A
authors: KEA
authors: Burns
authors: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada; Department of Medicine, McMaster University, Hamilton, Canada.
authors: Gordon
authors: G
authors: Guyatt
authors: Department of Anesthesiology and Centre de recherche FRSQ du CHA, Université Laval, Québec, Canada.
authors: Alexis F
authors: AF
authors: Turgeon
authors: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada.
authors: Qi
authors: Q
authors: Zhou
authors: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada; Department of Medicine, McMaster University, Hamilton, Canada.
authors: Maureen O
authors: MO
authors: Meade
mesh_terms: D000328:Adult; D002170:Canada; D015897:Comorbidity; D003422:Critical Care / Q000379:methods*; D019538:Health Care Surveys; D006801:Humans; D007022:Hypotension / Q000188:drug therapy; D009638:Norepinephrine / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012772:Shock, Septic / Q000188:drug therapy*; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
chemical_list: D014662:Vasoconstrictor Agents; D009638:Norepinephrine