SHM Converge Scientific Abstract ePoster Gallery-Trends in Continuation of Alpha-1 Agonist Midodrine Upon Icu Discharge

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This poster summarizes a retrospective chart review on the continuation of midodrine after ICU discharge at the University of New Mexico Hospital. Midodrine is an oral alpha-1 agonist used to raise blood pressure and help patients with persistent hypotension, especially those recovering from circulatory shock, come off IV vasopressors sooner and leave the ICU earlier. However, there is little evidence about how it is managed after ICU discharge.<br /><br />The study aims to identify the reasons midodrine is continued after ICU discharge, how clinicians taper or stop it outside the ICU, and how often patients leave the hospital on midodrine. Prior research by Rizvi et al. suggested that discharge on midodrine may shorten ICU length of stay and reduce in-hospital mortality, but continuing it after hospital discharge may increase 1-year mortality.<br /><br />Initial results included 35 patients: 21 male and 14 female, with an average age of 60.4 years. The most common indication for midodrine was septic shock, followed by chronic preexisting use, hypovolemic shock, neurogenic shock, renal failure, cirrhosis, and cardiogenic shock. Midodrine was most often started in the floor setting, then the ICU, and sometimes in the emergency department. Many patients were also receiving norepinephrine.<br /><br />Among patients who survived hospitalization, 58% were discharged on midodrine, and 16.6% of those were also discharged on an antihypertensive medication. Clinicians most often used a hard stop rather than tapering midodrine at discharge. Average ICU stay was 4.2 days, and only one adverse event was linked to midodrine.<br /><br />The authors plan further chart review and statistical analysis to help guide physician decisions about whether to continue midodrine after ICU discharge.

Asset Subtitle

Fahad Hussain

Meta Tag

Author List Deepti Rao, Fahad Hussain, Johnathan Jensen, Mary-Trynee Canete

Category Research

Concept Midodrine

Concept Intravenous Vasopressor

Concept Persistent Hypotension

Concept Alpha-1 Agonist

Concept ICU Discharge

Distinguished Non-Finalist

Presenter Organization University of New Mexico School of Medicine

Presenting Author Fahad Hussain

Track Quality Improvement

Keywords

midodrine

ICU discharge

retrospective chart review

persistent hypotension

vasopressors

septic shock

alpha-1 agonist

hospital discharge

tapering

University of New Mexico Hospital

Midodrine

Intravenous Vasopressor

Persistent Hypotension

Alpha-1 Agonist

ICU Discharge