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Open Access

Intraoperative vasopressor use during emergency surgery on injured meth users

Alexandra Marie Edwards, Eric Gregory Johnson, Andrew C. Bernard
DOI: 10.1136/tsaco-2020-000553 Published 11 November 2020
Alexandra Marie Edwards
1Department of Obstetrics, Gynecology and Womens’s Health, St. Louis University, St. Louis, Missouri, USA
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Eric Gregory Johnson
2Department of Pharmacy, University of Kentucky, Lexington, Kentucky, USA
3Department of Pharmacy Practice, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA
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Andrew C. Bernard
4Department of Surgery, University of Kentucky Medical Center, Lexington, Kentucky, USA
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Article Figures & Data

Tables

  • Table 1

    Characteristics of patients who received no vasopressors compared with those who received any vasopressors during operation

    FactorNo vasopressor (n=60)1 or more vasopressor doses (n=32)P value
    Age31 (±18)37 (±17)0.045
    Male gender, n (%)45 (75)26 (81)0.496
    White race, n (%)58 (96)32 (100)0.580
    Polysubstance on UDS, n (%)51 (85)28 (87)0.743
    Mechanism of injury, penetrating, n (%)21 (35)19 (59)0.025
    ISS (continuous)12 (±13)13.5 (±12)0.708
    ISS categories and scores: (n, % within group)0.305
     Mild (<9)10 (16)8 (19)
     Moderate (9–15)26 (43)9 (28)
     Severe (16–25)15 (25)12 (44)
     Profound (>25)9 (15)3 (9)
    OR duration2.5 (±9)2.75 (±7.5)0.760
    ASA class, n (% within group)<0.01
     12 (3.3)0 (0)
     230 (50)7 (21)
     312 (20)17 (53)
     47 (11)5 (15)
     59 (15)3 (9)
    Emergent OR, n (%)36 (60)24 (75)0.150
    Intubation prior to OR, n (%)20 (33)11 (34)0.920
    • ASA, American Society of Anesthesiologists; ISS, Injury Severity Score; OR, Operating Room ; UDS, urine drug screen.

  • Table 2

    Hemodynamic variables of patients who received vasopressors in the operating room compared with those who did not

    FactorNo vasopressor
    (n=60)
    1 or more vasopressor doses
    (n=32)
    P value
    Preoperative MAP85 (±19)85 (±127)0.718
    Base deficit on initial VBG/ABG−0.3 (IQR 5)−3 (IQR 22)0.02
    Transfused, n (%)12 (20)8 (40)0.580
    Transfusion, number of units of product0 (±24)0 (±15)0.605
    EBL100 (±325)200 (±249)0.230
    EKG changes requiring treatment03 (9.4)0.016
    20% change in MAP33 (55)26 (81)0.012
    MAP change requiring treatment, n (%)14 (23)23 (71)<0.001
    • ABG, arterial blood gas; EBL, estimated blood loss; EKG, electrocardiogram; MAP, mean arterial pressure; VBG, venous blood gas.

  • Table 3

    OR for one or more vasopressor doses

    FactorBSEWalddfP valueOR (95% CI for OR)
    Age0.0670.0266.7010.0101.06 (1.01 to 1.12)
    MOI0.9480.5233.28010.0702.58 (0.93 to 7.19)
    ASA class−0.1650.2870.33110.5650.848 (0.48 to 1.48)
    Base deficit−0.1400.0595.5610.0180.87 (0.77 to 0.97)
    Change in MAP by 20%1.770.6856.6910.0105.8 (1.5 to 22.4)
    • ASA, American Society of Anesthesiologists; MAP, Mean Arterial Pressure; MOI, mechanism of injury.

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Intraoperative vasopressor use during emergency surgery on injured meth users
Alexandra Marie Edwards, Eric Gregory Johnson, Andrew C. Bernard
Trauma Surg Acute Care Open Nov 2020, 5 (1) e000553; DOI: 10.1136/tsaco-2020-000553

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Intraoperative vasopressor use during emergency surgery on injured meth users
Alexandra Marie Edwards, Eric Gregory Johnson, Andrew C. Bernard
Trauma Surg Acute Care Open Nov 2020, 5 (1) e000553; DOI: 10.1136/tsaco-2020-000553
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Intraoperative vasopressor use during emergency surgery on injured meth users
Alexandra Marie Edwards, Eric Gregory Johnson, Andrew C. Bernard
Trauma Surgery & Acute Care Open Nov 2020, 5 (1) e000553; DOI: 10.1136/tsaco-2020-000553
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