A Retrospective Observational Evaluation of the Incidence of Tachycardia in Obese Patients receiving Norepinephrine Treatment for Septic Shock

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-9-2025

Abstract

According to the Surviving Sepsis campaign guidelines, norepinephrine is recommended as the first line vasopressor for septic shock. It is dosed either through fixed rate or weight-based dosing and titrated to goal mean arterial pressure. Norepinephrine is an alpha-adrenergic and beta1 agonist, producing vasoconstriction, chronotropic and inotropic effects, leading to tachycardia as an adverse effect. Given the dose of norepinephrine is determined using actual body weight, there is increased drug exposure in patients with higher body weights. The overall objective of this study is to retrospectively evaluate the incidence of tachycardia as defined by any heart rate greater than 110 beats per minute (BPM), in obese patients compared to normal body mass index (BMI) patients receiving norepinephrine during acute septic shock.

A retrospective observational study identified patients admitted to Corewell Health Butterworth and Blodgett intensive care units, who received norepinephrine as a first line agent for the treatment of septic shock. Patients were included if they had the diagnosis of septic shock and received norepinephrine for at least 12 hours. Patients were excluded if they had an underweight BMI, were started on a different vasopressor before norepinephrine or if there was a diagnosis of shock related to other etiologies. Patients were categorized as normal, obese, and morbidly obese based on their BMI. The primary endpoint was to analyze the incidence of tachycardia between these categories for patients receiving weight-based dosing of norepinephrine for septic shock. Secondary outcomes included analyzing the total norepinephrine exposure and investigating the occurrence of new onset arrythmias (i.e. atrial fibrillation, ventricular fibrillation, et cetera).

The results of this study are still pending.

The results of this study will help to assess incidence of tachycardia in obese and morbidly obese patients receiving norepinephrine for septic shock. Final conclusions will be presented at Research Day pending study results.

Comments

2025 Research Day Corewell Health West, Grand Rapids, MI, May 9, 2025. Abstract 1713

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