Hemodynamics, fluids & transfusion
Noradrenaline dose cutoffs to characterise the severity of cardiovascular failure: Data‐based development and external validation
Authors' conclusion
The highest noradrenaline dose is a useful measure for quantifying circulatory failure. Cutoffs 0.2 and 0.4 μg/kg/min seem to be suitable for defining low, intermediate and high doses.
Study context
- Population
- Intensive care unit (ICU) patients; development: Kuopio University Hospital, Finland, 2013–2019; validation: eICU database, 29 US ICUs, 2014–20158,079 development, 39,007 validation admissions
- Comparison
- Low (<0.2), intermediate (0.2-0.4) and high (>0.4 μg/kg/min) highest noradrenaline dose in first 24 h vs no noradrenaline
- Outcome
- Noradrenaline dose cutoffs based on association with hospital mortality
Methodological detailsbinational, development and external validation cohorts
- Binational
- Development and external validation cohorts
Performance
As reported in the abstract
Log-rank statistic peaks (dose cutoffs)
Two most prominent log-rank peaks at noradrenaline doses (μg/kg/min)
0.20 and 0.44
Cutoffs defined (μg/kg/min)
0.2 and 0.4
Further findings
Hospital mortality, development cohort
| Outcome | HR | P value |
|---|---|---|
| In-hospital death, validation cohortLow-dose vs No noradrenaline | 1.4 | P < 0.001 |
| In-hospital death, validation cohortIntermediate-dose vs No noradrenaline | 4.0 | P < 0.001 |
| In-hospital death, validation cohortHigh-dose vs No noradrenaline | 7.5 | P < 0.001 |
Original publication
Noradrenaline dose cutoffs to characterise the severity of cardiovascular failure: Data‐based development and external validation. Acta Anaesthesiol Scand. Published 30 August 2024. doi:10.
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