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Survey of the use of catecholamines by French physicians

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Abstract

Objective

The objective of the study was to perform a descriptive approach of the current use of catecholamines by French physicians.

Design

A questionnaire of 12 questions with 4 items established by a group of French intensivists.

Population

French physicians from 433 departments working in the following practicing areas: intensive care unit (ICU), emergency department, and pre-hospital setting.

Measurements

Responding physicians were asked about the catecholamine that they would select in various clinical settings.

Results

The response rate was 82%. Of the responding physicians, 277 (78%) worked in an ICU, 28 (8%) in an emergency department, and 21 (6%) in a pre-hospital setting. Dobutamine was chosen for patients with cardiogenic shock by 90% of the respondents. Norepinephrine was the first choice agent as vasopressor in patients with septic shock in 52% of the cases. Dopamine was selected in a clinical setting requiring an optimization of regional blood flow, as in the concept of high-risk surgical patients. Dopexamine was used as a second or third choice agent to improve regional blood flow and cardiac output. The indications of epinephrine for anaphylactic shock and cardio-circulatory arrest were obvious for more than 90% of responding physicians.

Conclusion

A lack of standardization appears in the use of catecholamines by French physicians, particularly for improvement of regional circulation and management of high-risk surgical patients. Guidelines that define the place of each catecholamine in these settings are required to improve the quality of prescription.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care and Trauma Center, Marseille University Hospital System Marseille School of Medicine, 13915 , Marseille cedex 20, France

    Marc Leone & Claude Martin

  2. Department of Anesthesiology and Intensive Care, Lille University Hospital System Lille School of Medicine, Lille, France

    Benoit Vallet

  3. Medical Intensive Care Unit Centre Hospitalier Universitaire de Bicêtre, Assistance Publique-Hôpitaux de Paris Le Kremlin-Bicêtre, Université Paris XI, France

    Jean-Louis Teboul

  4. Department of Anesthesiology and Intensive Care, Centre Hospitalier Universitaire Lariboisière, Paris, France

    Joachim Mateo

  5. Department of Anesthesiology and Intensive Care, Hôpital Cardiovasculaire et Pneumologique L. Pradel, Lyon, France

    Olivier Bastien

Authors
  1. Marc Leone
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  2. Benoit Vallet
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  3. Jean-Louis Teboul
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  4. Joachim Mateo
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  5. Olivier Bastien
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  6. Claude Martin
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Corresponding author

Correspondence to Marc Leone.

Electronic Supplementary Material

Appendix

Appendix

Questionnaire

  1. 1.

    Among the following adrenergic agents, which one would you use as first, second, third or fourth choice for the treatment of patients with cardiogenic shock?

    • Dobutamine/Dopexamine/Milrinone-Amrinone/Epinephrine

  2. 2.

    Among the following vasopressor agents, which one would you use as first, second, third or fourth choice for the treatment of patients with septic shock?

    • Dopamine/Norepinephrine/Epinephrine/Phenylephrine

  3. 3.

    If a patient with septic shock is already receiving a vasopressor, among the following inotropic agents, which one would you use as first, second, third or fourth choice?

    • Dobutamine/Dopexamine/Milrinone-Amrinone/Epinephrine

  4. 4.

    If a patient with septic shock is already receiving an inotropic agent, among the following vasopressor agents, which one would you use as first, second, third or fourth choice?

    • Phenylephrine/Norepinephrine/Epinephrine/Dopamine

  5. 5.

    In order to improve regional blood flow, among the following inotropic agents, which one would you use as first, second, third or fourth choice?

    • Dopamine/Isoprenalline/Dopexamine/Dobutamine

  6. 6.

    In order to improve renal blood flow, among the following inotropic agents, which one would you use as first, second, third or fourth choice?

    • Dopexamine/Dobutamine/Isoprenalline/Dopamine

  7. 7.

    In order to manage high-risk surgical patients, among the following inotropic agents, which one would you use as first, second, third or fourth choice?

    • Dopexamine/Dobutamine/Isoprenalline/Dopamine

  8. 8.

    In order to manage high-risk surgical patients, among the following vasopressor agents, which one would you use as first, second, third or fourth choice?

    • Dopamine/Norepinephrine/Epinephrine/Phenylephrine

  9. 9.

    When would you use epinephrine as the first choice agent?

    • Cardiogenic shock/Septic shock/Anaphylactic shock/Cardiocirculatory arrest

  10. 10.

    When you prescribe an inotropic agent, what type of monitoring do you use?

    • Arterial catheter/Swan-Ganz catheter/Transesophageal Doppler/Gastric tonometry

  11. 11.

    What is your primary specialty? (one response)

    • ICU physician/Emergency physician/Pre-hospital physician

  12. 12.

    You are working in a: (one response)

    • Teaching hospital/Community hospital/Private hospital/Pre-hospital care

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Leone, M., Vallet, B., Teboul, JL. et al. Survey of the use of catecholamines by French physicians. Intensive Care Med 30, 984–988 (2004). https://doi.org/10.1007/s00134-004-2172-1

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  • DOI: https://doi.org/10.1007/s00134-004-2172-1

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