Hemodynamics, fluids & transfusion
Variation in Maximal Doses of Vasopressors Used for Treatment of Shock in Intensive Care Units in Alberta Canada: A Retrospective Cohort Study
Main finding · Receipt of high-dose maximum vasopressor between ICUsResult — go to the resultaMOR 1.89 95% CI 1.50–2.40Authors' conclusion
In Alberta CA, the maximum combined vasopressor dose for patients with shock varied between ICUs after adjustment for severity of illness. Some survival occurred even with high maximal doses.
Study context
- Population
- Adults with shock (one or more vasopressors for at least 6 hours) admitted to 21 intensive care unit (ICUs) in Alberta, Canada
- Participants
- 28,397 ICU admissions
- Exposure
- Variation in maximum vasopressor doses between ICUs
- Outcome
- Variation between ICUs in receipt of high-dose maximum NEQ (adjusted median OR, aMOR)
Methodological detailsmulticentre, multi-level logistic regression
- Multicentre
- Multi-level logistic regression
Main finding
As reported in the abstract
Receipt of high-dose maximum vasopressor between ICUs
Adjusted median odds ratio (aMOR)
1.89
95% CI 1.50–2.40
Between ICUs
aMOR 1.89 (95% CI 1.50–2.40)
- 90th percentile of unadjusted maximum NEQ dose
- 0.7 µg/kg/min
- Full range of maximum NEQ dose
- 0.01-7.3 µg/kg/min
- 1st to 99th percentile
- 0.03-2.0 µg/kg/min
- 10th percentile
- 0.1 µg/kg/min
- Percent of patients per ICU receiving high-dose maximum vasopressor (≥0.7 µg/kg/min)
- 3.6% to 32.1%
Observational data: associations, not effects.
Further findings
Hospital survival
P < 0.001
90th percentile cutoffs for high-dose maximum, individual vasopressors
- Norepinephrine
- 0.5 µg/kg/min
- Epinephrine
- 0.5 µg/kg/min
- Phenylephrine
- 316.5 µg/min
- Dopamine
- 15.0 µg/kg/min
- Vasopressin
- 3.6 units/h
Hospital survival
- No clear dosing cutoff above which survival to hospital discharge was impossible
Original publication
Variation in Maximal Doses of Vasopressors Used for Treatment of Shock in Intensive Care Units in Alberta Canada: A Retrospective Cohort Study. Anesth Analg. Published 29 October 2025. doi:10.
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