For a study, researchers sought to assess the use of push dose pressors (PDP) in critically sick patients outside of the operating room (OR), practice patterns, and safety at a significant academic medical facility.

The 1,273-bed academic medical hospital hosted a single-center, retrospective cohort research (June 2018 to July 2020). The cohort was assessed based on PDP response, and the primary outcome was effectiveness, which was determined as a 25% rise in systolic blood pressure (i.e., responders versus non-responders). In addition, a logistic regression model evaluated the determinants of responsiveness to PDPs. The prevalence of hypertension, bradycardia, and tachycardia were among the safety outcomes.

The final analysis comprised 1,727 patients. Phenylephrine and epinephrine were provided at median dosages of 400μg (IQR 200-888μg) and 50μg (IQR 20-100μg), respectively. In the epinephrine group, 102 patients (71.8%) and 1,140 patients (55.9%) met the main result in the phenylephrine group. The most frequent adverse effects following PDP administration were hypertension, which occurred in 6.6% and 13.4% of the epinephrine and phenylephrine groups, respectively.

The study illustrated the safety and effectiveness of PDP phenylephrine and epinephrine in treating acute hypotensive episodes.

Reference: sciencedirect.com/science/article/pii/S0735675722005575