Leone Marc, Vallet Benoit, Teboul Jean-Louis, Mateo Joachim, Bastien Olivier, Martin Claude
Department of Anesthesiology and Intensive Care and Trauma Center, Marseille University Hospital System, Marseille School of Medicine, 13915 Marseille cedex 20, France.
Intensive Care Med. 2004 May;30(5):984-8. doi: 10.1007/s00134-004-2172-1. Epub 2004 Mar 3.
The objective of the study was to perform a descriptive approach of the current use of catecholamines by French physicians.
A questionnaire of 12 questions with 4 items established by a group of French intensivists.
French physicians from 433 departments working in the following practicing areas: intensive care unit (ICU), emergency department, and pre-hospital setting.
Responding physicians were asked about the catecholamine that they would select in various clinical settings.
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.
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.
本研究的目的是对法国医生目前使用儿茶酚胺的情况进行描述性分析。
由一组法国重症监护专家制定了一份包含12个问题、4个条目的问卷。
来自433个科室的法国医生，其工作领域包括：重症监护病房（ICU）、急诊科和院前急救环境。
询问回复问卷的医生在各种临床情况下会选择使用的儿茶酚胺。
回复率为82%。在回复问卷的医生中，277名（78%）在ICU工作，28名（8%）在急诊科工作，21名（6%）在前院急救环境工作。90%的受访者选择多巴酚丁胺用于心源性休克患者。52%的情况下，去甲肾上腺素是感染性休克患者血管升压药的首选。在需要优化局部血流的临床情况下，如高危手术患者的概念中，选择多巴胺。多培沙明被用作改善局部血流和心输出量的第二或第三选择药物。超过90%的回复医生认为肾上腺素用于过敏性休克和心肺循环骤停的指征很明显。
法国医生在儿茶酚胺的使用上缺乏标准化，特别是在改善局部循环和高危手术患者的管理方面。需要制定指南来明确每种儿茶酚胺在这些情况下的应用，以提高处方质量。
