Analysis of Mortality in

Patients Treated with

Phenylephrine in Septic
Shock
Presented by Haleigh Brooks
 L.G, 91 year old male
presented to emergency
Patient’s primary medical
department with respiratory
diagnosis was septic shock.
distress, hypotension, and
infection.
Patient
Situation Patient had prior medical history
of chronic kidney disease, BPH,
Patient was admitted due to
hypertension, type 2 diabetes,
respiratory complications and
heart failure, A-fib, ischemic
hemodynamic instability. cardiomyopathy, and
hypercholesterolemia.
Nursing Diagnoses

 Top 3 Nursing Problems:

1. Impaired gas exchange
a. Presence of pneumonia
b. Patient required oxygen via nasal cannula to maintain adequate oxygen saturation
2. Deficient fluid volume
a. Patient experiencing septic shock
b. Administration of vasopressin and norepinephrine needed to maintain blood pressure
within normal limits
3. Decreased cardiac output
a. Patient history of heart failure with reduced ejection fraction
b. Resulting in inadequate tissue perfusion
  The target population for this study was all adult patients
admitted to an ICU on vasopressors for management of septic
shock.
 Exclusions: Pregnant women, use of vasopressors for other causes,
salvage therapy
 Systemic Inflammatory Response Syndrome (SIRS) criteria were
Research used to identify patients for the study.
 Use of the Sepsis-3 definition
Methods  Two groups of patients were created: those treated with
phenylephrine and those who were not.
 The primary objective was to compare mortality rates between
the two patient groups.
 Fischer’s exact test was used for all nominal data while T-test was
used for all continuous data.
Research Findings

 Out of the 469 patients included in the study, 148 patients received treatment
with phenylephrine and 321 did not.
 A statistically significant increase in mortality was noted in the group that
received phenylephrine treatment.
 56% mortality rate compared to 41%
 Factors of length of ICU stay and days on vasopressors were considered when
calculating results.
 This study concluded that patients had a higher mortality rate when septic shock
requiring use of vasopressors was treated with phenylephrine compared to
without phenylephrine.
  Based on the evidence found in this study, use of phenylephrine
Research should be avoided in patients with septic shock unless other
vasopressors have been attempted and deemed ineffective in
Application: stabilizing blood pressure.

Evidence  These findings can be applied to the patient by not initiating

phenylephrine unless his current vasopressors (norepinephrine
Based Practice and vasopressin) would become ineffective at achieving
hemodynamic stability.
  Patel, V. V., Sullivan, J. B., & Cavanaugh, J. (2023). Analysis of
Mortality in Patients Treated with Phenylephrine in Septic
References Shock. Journal of Pharmacy Practice, 36(1), 15–18.
https://doi.org/10.1177/08971900211000218.