Table 2 Studies to determine the conversion ratio of each vasopressor agent in our updated NEE formula
From: An updated “norepinephrine equivalent” score in intensive care as a marker of shock severity
Author | Year | Journal | Equipotency with norepinephrine |
|---|---|---|---|
Epinephrine | |||
Myburgh et al. [29] | 2008 | Intensive Care Med | There was no difference in the maximal daily infusion dose between norepinephrine and epinephrine |
Annane et al. [30] | 2007 | Lancet | The doses of vasopressors needed to achieve the mean arterial pressure target were not different between epinephrine and norepinephrine |
Dopamine | |||
Marik et al. [32] | 1994 | JAMA | 26 µg/kg/min of dopamine was equivalent to 0.18 µg/kg/min of norepinephrine |
De Backer et al. [31] | 2003 | Crit Care Med | The median dose of dopamine was 15 µg/kg/min, while that of norepinephrine was 0.18 µg/kg/min |
De Backer et al. [33] | 2010 | New England Journal of Medicine | The dose of dopamine was consistently 100 times as much as that of norepinephrine during seven days after randomization |
Phenylephrine | |||
Reinelt et al. [34] | 1999 | Crit Care Med | 3.2 µg/kg/min of phenylephrine was equipotent to 0.2 µg/kg/min of norepinephrine |
Ngan Kee et al. [35] | 2015 | Anesthesiology | 39.1 µg/min of phenylephrine was equivalent to 2.4 µg/min of norepinephrine |
Vasopressin | |||
Russell et al. [13] (VASST) | 2008 | New England Journal of Medicine | The addition of 0.03 U/min of vasopressin reduced 7.5 µg/min of norepinephrine |
Gordon et al. [36] | 2016 | JAMA | The addition of 0.06 U/min of vasopressin reduced norepinephrine dose by 0.15 µg/kg/min |
Other vasopressor agents | |||
Khanna et al. [15] | 2017 | New England Journal of Medicine | 20 ng/kg/min of angiotensin II infusion resulted in a mean reduction of 0.05 µg/kg/min of norepinephrine compared with the placebo |
Liu et al. [37] | 2018 | Intensive Care Med | The dose of terlipressin required to reach the mean arterial pressure target was ten times lower than that norepinephrine dose |
Natalini et al. [38] | 2005 | Intensive Care Med | 2.5 μg/kg/min of metaraminol corresponded to 0.3 μg/kg/min of norepinephrine |
Patel et al. [39] | 2022 | Chest | 5 g of hydroxocobalamin reduced norepinephrine requirement by 0.08 µg/kg/min |
Adly et al. [40] | 2022 | Ir J Med Sci | 30 mg/day of midodrine reduced 73 mg of norepinephrine during six days |
Kirov et al. [41] | 2001 | Crit Care Med | Methylene blue infusion ranged from 0.25 to 2 mg/kg/h, while norepinephrine ranged from 0.1 to 0.7 µg/kg/min |