Every year, thousands of patients are treated in Québec's intensive care units and many are in shock when they arrive: their blood stops flowing normally, causing their blood pressure to drop and threating their vital organs. Physicians generally prescribe vasopressors—drugs that jumpstart the cardiovascular system to increase blood pressure. In fact, the results of a pilot project led by Dr. François Lamontagne, specialist in internal medicine and intensive care at the Centre hospitalier universitaire de Sherbrooke (CHUS), reveal that medical professionals tend to overuse vasopressors, especially in patients 75 years of age and older.
Medical professionals tend to overuse vasopressors, especially in patients 75 years of age and older.
The medication must be administered carefully: the wrong dose can lead to major complications, including arrhythmia and intestinal and renal failure. But there is no scientifically proven protocol to ensure patients receive the optimal and safe dose. Dr. Lamontagne, who is also a researcher at the Centre de recherche du CHUS and Université de Sherbrooke, therefore launched the OVATION study to optimize the use of vasopressors for hypotension. He mobilized teams of doctors, pharmacists and nurses who followed 180 patients in 17 intensive care units across Canada and the US to test treatment protocols and observe current clinical practices.
A particular finding emerged from the two projects: patients are given vasopressors too often and their blood pressure exceeds recommended targets. In addition, it seems that older patients benefit from the more restrictive use of the drugs. To corroborate his conclusions, Dr. Lamontagne will soon join forces with experts in France and the UK. Until then, he recommends that the administration of vasopressors be better monitored in order to ensure that the right dose is given to the right patient!
Aiming for safer ICU care, video by François Lamontagne