HealthDay News — According to a study published in the Journal of the American Medical Association to coincide with the annual International Symposium on Intensive Care and Emergency Medicine in Brussels, the rate of in-hospital mortality was increased for patients with septic shock in US hospitals affected by a 2011 norepinephrine shortage.
In a retrospective cohort study, Emily Vail, MD, from Columbia University in New York City, and colleagues examined changes to patient care and outcomes associated with a 2011 national shortage of norepinephrine.
Data were included for 27,835 adults with septic shock admitted to 26 US study hospitals between July 1, 2008, and June 30, 2013. The researchers observed a decrease in norepinephrine use in the hospitals that demonstrated at least one quarter of norepinephrine shortage in 2011, from 77.0% of patients before the shortage to a low of 55.7% in the second quarter of 2011; during this time, the most frequently used alternative vasopressor was phenylephrine (baseline, 36.2%; maximum, 54.4%).
During quarters of shortage, hospital admission correlated with an increased rate of in-hospital mortality compared with hospital admission with septic shock during quarters of normal use (39.6 versus 35.9%, respectively; adjusted odds ratio, 1.15).
“Among patients with septic shock in US hospitals affected by the 2011 norepinephrine shortage, the most commonly administered alternative vasopressor was phenylephrine,” the authors write.
Vail E, et al. Association Between US Norepinephrine Shortage and Mortality Among Patients With Septic Shock. JAMA. Published online March 21, 2017. doi:10.1001/jama.2017.2841
Donohue JM, Angus DC. National Shortages of Generic Sterile Injectable DrugsNorepinephrine as a Case Study of Potential Harm. JAMA. Published online March 21, 2017. doi:10.1001/jama.2017.2826