Hemodynamic Effects of an Increased Midodrine Dosing Frequency

Macielak, Shea A; Vollmer, Nicholas J; Haddad, Natalie; Nabzdyk, Christoph G S; Nei, Scott D

doi:10.1097/cce.0000000000000405

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…However, this was not the intention of this pilot study, and we will focus on these outcomes in the subsequent multicentered RCT. Finally, there is some suggestion that a higher dose of midodrine may be used (30). However, the product monograph states that our dosing is the highest suggested by the manufacturer and is the most commonly used dosing regime in studies evaluating the role of midodrine in critically ill patients (Supplementary File 4).…”

Section: Discussionmentioning

confidence: 99%

Midodrine for the early liberation from vasopressor support in the ICU (LIBERATE): A feasibility study

Kilcommons,

Hammal,

Opgenorth

et al. 2024

Preprint

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Background: Malnutrition is the most common nutritional disorder in developing countries and it remains one of the most common causes of morbidity and mortality among children worldwide. Childhood malnutrition is a multi-dimensional problem. An increase in household income is not sufficient to reduce childhood malnutrition if children are deprived of food security, education, access to water, sanitation and health services. However, due to regional variations in prevalence of acute malnutrition, it is important to explore the risk factors specific to the region, for designing and implementing public health interventions. Objective: To assess the prevalence and risk factors of malnutrition among children under five years Methods: A descriptive study enrolled 100 children under five years in Helat Hassan Health Centre, Wad-Medani, Gezira State during the period from November 2020 - March 2021. Data regarding children and families characteristics, nutritional history, health and medical history and anthropometric measurements were collected. Malnutrition was defined according to WHO guideline as -3SD of age specific BMI Results: Among 100 children, 59(59%) males and 41(41%) females, their mean age was 33±18 months. The frequency of malnutrition was 10% (n=10) and underweighting was 18% (n=18). Child's related risk factors associated with malnutrition were; children order above 4th (P. value= 0.000) and number of under 5 children in family above 3 children (P. value= 0.00). Family's related risk factors associated with malnutrition were; younger mother blow 30 years (P. value= 0.001), non-mother (relative) caregivers (P. value= 0.000), illiterate mothers (P. value= 0.046), employed mothers (P. value= 0.000), relative as income responsible (P. value= 0.009), lack of medical insurance (P. value= 0.047), lack of in-home source of water (P. value= 0.003), and low income blow 6,000 SDG (P. value= 0.000). Nutritional related risk factors associated with malnutrition were; lack of exclusive breastfeeding (P. value= 0.000), less than three meals per day (P. value= 0.021), lack of vegetables and fruits in daily nutrition (P. value= 0.006) and lack of milk and dietary products in daily nutrition (P. value= 0.000). Health related risk factors associated with malnutrition were; illness as cause of health care center visit (P. value= 0.018), anemia (P. value= 0.002), admission to hospital in last 2 months (P. value= 0.005), fever, cough, runny rose or chest infection in last 2 weeks (P. value= 0.032), chronic diarrhea (20.7%; P. value= 0.018) and history of malnutrition (P. value= 0.001). Conclusion: The frequency of malnutrition is not neglectable in Helat Hassan Health Centre at Wad-Medani. Malnutrition was found to be multi-factorial and associated with child, family, nutritional and health related factors. Effective, efficient and equitable program and intervention should be designed to reduce child malnutrition

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Section: Discussionmentioning

confidence: 99%

Midodrine for the early liberation from vasopressor support in the ICU (LIBERATE): A feasibility study

Kilcommons,

Hammal,

Opgenorth

et al. 2024

Preprint

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“…An alternative approach could involve increased dosing frequency of midodrine given its 3-hour half-life. A retrospective study of 23 patients receiving midodrine at 6-hourly intervals to wean off intravenous vasopressors 99 found this regimen to be safe. Prospective trials are required to test this hypothesis.…”

Section: Further Considerations In the Critically Ill Patientmentioning

confidence: 99%

Midodrine use in critically ill patients: a narrative review

Costa-Pinto¹,

Jones²,

Udy³

et al. 2022

Critical Care and Resuscitation

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Midodrine is a peripherally acting, oral α-agonist that is increasingly used in intensive care units despite conflicting evidence for its effectiveness. It has pharmacological effects on blood vessels as well as pupillary, cardiac, renal, gastrointestinal, genitourinary, lymphatic and skin tissue. It has approval for use as a treatment for orthostatic hypotension, but a surge in interest over the past decade has prompted its use for a growing number of off-label indications. In critically ill patients, midodrine has been used as either an adjunctive oral therapy to wean vasoplegic patients off low dose intravenous vasopressor infusions, or as an oral vasopressor agent to prevent or minimise the need for intravenous infusion. Clinical trials have mostly focused on midodrine as an intravenous vasopressor weaning agent. Early retrospective studies supported its use for this indication, but more recent randomised controlled trials have largely refuted this practice. Key questions remain on its role in managing critically ill patients before intensive care admission, during intensive care stay, and following discharge. This narrative review presents a comprehensive overview of midodrine use for the critical care physician and highlights why lingering questions around ideal patient selection, dosing, timing of initiation, and efficacy of midodrine for critically ill patients remain unanswered.

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Letter to the Editor: “Midodrine to liberate ICU patients from intravenous vasopressors: Another negative fixed-dose trial”

Riker

Gagnon

2022

Journal of Critical Care

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Hemodynamic Effects of an Increased Midodrine Dosing Frequency

Cited by 3 publications

References 10 publications

Midodrine for the early liberation from vasopressor support in the ICU (LIBERATE): A feasibility study

Midodrine for the early liberation from vasopressor support in the ICU (LIBERATE): A feasibility study

Midodrine use in critically ill patients: a narrative review

Letter to the Editor: “Midodrine to liberate ICU patients from intravenous vasopressors: Another negative fixed-dose trial”

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