# Normalizing vasopressor dose to standardize vasopressors practice in septic shock

> **NIH NIH F32** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2021 · $28,410

## Abstract

PROJECT SUMMARY/ABSTRACT
We propose the “Normalizing vasopressor dose to standardize vasopressors practice in septic shock” study to
improve the standardization and knowledge of vasopressors during septic shock through the development of a
novel measure of vasopressor dose normalized to blood pressure response and through characterization of
vasopressor practice patterns. Sepsis is a common, life-threatening, dysregulated response to infection. Septic
shock is the most severe form of sepsis where circulatory and metabolic failure results in case fatality
approaching 50%. Vasopressor medications operationalize septic shock (septic shock is defined as
hypotension and hyperlactatemia requiring vasopressors to maintain organ perfusion) and vasopressor
choices have important implications for septic shock outcomes. Despite the importance of vasopressors in the
definition and management of septic shock, numerous knowledge gaps regarding vasopressor dosing and the
choice and timing of second vasopressors exist. These vasopressor knowledge gaps prevent standardization
of clinical practice and septic shock trials that hinder progress in improving vasopressor use in septic shock.
Simple measures that normalize dose to response have led to improved standardization and understanding of
disease severity in other critical care syndromes (e.g. PaO2/FiO2 in Acute Respiratory Distress Syndrome) but
no such measure exists in septic shock. We propose two necessary foundational steps to improve the
evaluation and use of vasopressors in septic shock using high-resolution critical care electronic health record
data: 1) develop and validate a measure of vasopressor dose normalized to blood pressure response with
strong predictive validity for septic shock mortality and 2) leverage hospital variation in vasopressor dosing to
determine the optimal timing of second vasopressor initiation when norepinephrine alone is inadequate.
Completion of this proposal will result in better understanding of the relationship between vasopressor dose,
blood pressure response and septic shock mortality, and develop novel tools for both clinicians and clinical
trialists to improve and standardize care. The rich collaborative environment at Boston University School of
Medicine and the individually-tailored gradated training plan outlined in this proposal are ideally suited to
support Dr. Bosch in accomplishing the study aims and to prepare him to apply for Mentored Career
Development funding with the ultimate goal of becoming a physician-scientist specializing in cardiovascular
critical care data science.

## Key facts

- **NIH application ID:** 10106468
- **Project number:** 5F32GM133061-02
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Nicholas A Bosch
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $28,410
- **Award type:** 5
- **Project period:** 2020-02-15 → 2021-06-27

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10106468

## Citation

> US National Institutes of Health, RePORTER application 10106468, Normalizing vasopressor dose to standardize vasopressors practice in septic shock (5F32GM133061-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10106468. Licensed CC0.

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