Current approaches to norepinephrine dosage calculation in anesthesiologist-intensivist practice (literature review)

Introduction. Norepinephrine is the first-line vasopressor therapy for septic shock, widely used in clinical practice and the results of its use are reflected in scientific research. However, its release in the form of various salt forms (tartrate, bitartrate, hydrochloride) in the absence of a unified approach to calculating dosage (by salt or by active base) leads to significant heterogeneity of the data. This makes it difficult to interpret study results, compare clinical data, and conduct meta-analyses.
The objective was to analyze the available information on the use of different forms of norepinephrine, and to assess its impact on clinical practice and researches.
Results. Particular attention was paid to the updated SOFA-2 scale, which for the first time includes a requirement to indicate the dose of norepinephrine in terms of the active base. An analysis of modern literature revealed that a significant portion of studies do not indicate the form of norepinephrine or use different units of measurement without conversion, which leads to methodological incomparability of data. This problem is global in nature and is identified in studies conducted in various countries.
Conclusions. The problem of the lack of standardization of norepinephrine dosing is a significant methodological and clinical limitation of modern intensive care. The use of different salt forms without specifying the conversion to the active base leads to heterogeneity of data, reduces the comparability of research results and may distort the interpretation of clinical outcomes.

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