Wieruszewski et al identified predictors of cardiac dysrhythmias for a patient receiving norepinephrine for septic shock. The authors are from the Mayo Clinic, Methodist University Hospital (Memphis), and the University of Tennessee.

Patient selection: septic shock, treated with norepinephrine


Exclusion: presence of dysrhythmia before starting norepinephrine


Dysrhythmias included:

(1) sinus tachycardia

(2) atrial flutter

(3) atrial fibrillation

(4) bradycardia

(5) supraventricular tachycardia

(6) ventricular fibrillation


Predictors of cardiac dysrhythmias:

(1) higher norepinephrine dose (mean dose 35 µg/min vs 15; OR 1.06 per 5 µg/min)

(2) longer duration of norepinephrine therapy (mean 51 hours vs 33; OR 1.007 per hour)

(3) add-on therapy with vasopressin or phenylephrine


The occurrence of cardiac dysrhythmia is associated with increased mortality.

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