title: [Major haemodynamic incident during continuous norepinephrine infusion: Beware of the infusion line. An avoidable postoperative hypertensive peak?].
abstract: The restoration of patients' mean arterial pressure after ineffective fluid resuscitation is obtained by vasopressive treatment such as norepinephrine. However, no guidelines exist concerning a norepinephrine infusion method: whether it be the norepinephrine concentration in the syringe, single or double pump administration via a carrier such as an isotonic saline solution, or use of minimized dead-volume extension sets. We present the case of a female patient requiring norepinephrine treatment, who quickly suffers a major haemodynamic incident (a sudden rise in systolic blood pressure above 220 mmHg associated with tachycardia up to 189 b/min). The main causes of this incident are discussed and infusion parameters considered with a view to developing an optimal infusion method for a drug with a specific therapeutic index.
authors.affiliation: Clinique d'anesthésie-réanimation, hôpital Claude-Huriez, CHRU Lille, 1, rue Michel-Polonovski, 59037 Lille cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Ethgen
authors.forename: S
authors.initials: S
authors.lastname: Genay
authors.forename: B
authors.initials: B
authors.lastname: Décaudin
authors.forename: P
authors.initials: P
authors.lastname: Odou
authors.forename: G
authors.initials: G
authors.lastname: Lebuffe
mesh_terms: D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000503:physiopathology; D007262:Infusions, Intravenous; D008113:Liver Neoplasms / Q000601:surgery; D019300:Medical Errors; D008875:Middle Aged; D009638:Norepinephrine / Q000008:administration & dosage / Q000009:adverse effects*; D011183:Postoperative Complications / Q000139:chemically induced*; D013610:Tachycardia / Q000139:chemically induced; D014336:Troponin / Q000097:blood; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D014336:Troponin; D014662:Vasoconstrictor Agents; D009638:Norepinephrine