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ToolsGramish, Jawaher, Hattan, Ahmed, Aljuhani, Ohoud, Parameaswari, P. J., Alshehri, Shaden, Korayem, Ghazwa B., Alkofide, Hadeel, Alalawi, Mai, Vishwakarma, Ramesh, Alsowaida, Yazed Saleh, Alqahtani, Rahaf, Binorayir, Luluh, Abutaleb, Mohammed, Alotaibi, Alanoud, Aljohani, Majidah, Aljohani, Sarah, Samreen, Sana, Jawhari, Suad, Alanazi, Raghad and Al Sulaiman, Khalid A. (2024) The Impact of Midodrine Tapering Versus Nontapering Regimens on the Clinical Outcomes of Critically Ill Patients: A Retrospective Cohort Study. Annals of Pharmacotherapy, 58 (3). pp. 223-233. ISSN 1060-0280
Full text not available from this repository. (Request a copy)Abstract
Background: Midodrine has been used in the intensive care unit (ICU) setting to reduce the time to vasopressor discontinuation. The limited data supporting midodrine use have led to variability in the pattern of initiation and discontinuation of midodrine. Objectives: To compare the effectiveness and safety of 2 midodrine discontinuation regimens during weaning vasopressors in critically ill patients. Methods: A retrospective cohort study was conducted at King Abdulaziz Medical City. Included patients were adults admitted to ICU who received midodrine after being unable to be weaned from intravenous vasopressors for more than 24 hours. Patients were categorized into two subgroups depending on the pattern of midodrine discontinuation (tapered dosing regimen vs. nontapered regimen). The primary endpoint was the incidence of inotropes and vasopressors re-initiation after midodrine discontinuation. Results: The incidence of inotropes or vasopressors’ re-initiation after discontinuation of midodrine was lower in the tapering group (15.4%) compared with the non-tapering group (40.7%) in the crude analysis as well as regression analysis (odd ratio [OR] = 0.15; 95% CI = 0.03, 0.73, P = 0.02). The time required for the antihypertensive medication(s) initiation after midodrine discontinuation was longer in patients who had dose tapering (beta coefficient (95% CI): 3.11 (0.95, 5.28), P = 0.005). Moreover, inotrope or vasopressor requirement was lower 24 hours post midodrine initiation. In contrast, the two groups had no statistically significant differences in 30-day mortality, in-hospital mortality, or ICU length of stay. Conclusion and Relevance: These real-life data showed that tapering midodrine dosage before discontinuation in critically ill patients during weaning from vasopressor aids in reducing the frequency of inotrope or vasopressor re-initiation. Application of such a strategy might be a reasonable approach among ICU patients unless contraindicated.
| Item Type: | Article |
|---|---|
| Additional Information: | Publisher Copyright: © The Author(s) 2023. |
| Uncontrolled Keywords: | midodrine,tapering,vasopressor re-initiation,vasopressor requirement,weaning,pharmacology (medical) ,/dk/atira/pure/subjectarea/asjc/2700/2736 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Centres > Public Health Faculty of Medicine and Health Sciences > Research Centres > Population Health (former - to 2025) |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 14 Apr 2026 13:34 |
| Last Modified: | 14 Apr 2026 13:34 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/102776 |
| DOI: | 10.1177/10600280231173290 |
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