Hemodynamics, fluids & transfusion
Droxidopa or Atomoxetine for Refractory Hypotension in Critically Ill Cardiothoracic Surgery Patients
Authors' conclusion
Droxidopa and atomoxetine are oral vasoactive agents with potential mechanisms to facilitate IV vasopressor weaning for patients in the ICU with hypotension refractory to midodrine, but further prospective research is needed.
Study context
- Population
- Cardiothoracic intensive care unit (ICU) patients with hypotension refractory to midodrine, receiving ≥4 consecutive doses of droxidopa or atomoxetine with concurrent midodrine72 charts reviewed
- Participants
- 45 patients
- Exposure
- Atomoxetine vs droxidopa vs both, added to midodrine
- Atomoxetinen = 18
- Droxidopan = 17
- Bothn = 10
- Outcome
- Time to discontinuation of intravenous (IV) vasoactive agents after initiation of study medication
Methodological detailssingle-centre, hypothesis-generating
- Single-centre
- Hypothesis-generating
Main finding
As reported in the abstract
Median time to discontinuation of IV vasoactive agents
P = 0.259
Observational data: associations, not effects.
Further findings
Survival to hospital discharge — Both vs Atomoxetine · both or droxidopa alone vs atomoxetine alone
P = 0.028
ICU or hospital LOS
- No differences between groups
Original publication
Droxidopa or Atomoxetine for Refractory Hypotension in Critically Ill Cardiothoracic Surgery Patients. J Cardiothorac Vasc Anesth. Published 21 September 2023. doi:10.
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