Postoperative Vasopressor Usage: SQUEEZE

NCT03805230 | Completed

• 1 other identifier: SQUEEZE
• Study Type: observational
• Target: 25,000
• Locations: 2 countries
• Sites: 2

Brief Summary

A prospective multi-centre international observational study of postoperative vasopressor use, designed to answer the question: 'What is the proportion of patients that receive vasopressor infusions? In the management of these patients;

• Are there variations in the practice between clinicians, hospitals or countries? If yes, are they associated with clinical outcome?
• What are the health economic impacts associated with receiving vasopressors?

Conditions

Surgical Procedures, Operative; Vasopressor

Keywords

anaesthesia; Intensive Care; vasopressor

Outcome Measures

Primary Outcomes (1)

• Prevalence of postoperative vasopressor usage in a none cardiac surgical population.

  1\. What proportions of patients receive infused vasopressors postoperatively?

  A the primary endpoint is the proportion of patients receiving vasopressor infusions that start between 1 and 24 hours postoperatively

Study Arms (2)

Cohort A

all patients admitted to participating hospitals during 7 consecutive days

Cohort B

30 sequential patients with a single additional inclusion criterion

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult Patients undergoing any non-cardiac surgical procedure.

You may qualify if:

• Undergoing surgery (may be planned or unplanned)
• No plans for return home on the day of surgery, for medical reasons
• Age ≥ 18 on day of surgery

You may not qualify if:

• Cardiac surgery
• Obstetric surgery
• Transplant surgery
• Receiving long-term infusions of vasoactive drugs, such as epoprostenol
• Mechanical circulatory support: ventricular assist device, intra-aortic balloon pump, artificial heart or similar
• Already been enrolled in Squeeze
• Receiving infusion of vasopressors that continues after the patient has left the operating room.

Sponsors & Collaborators

• European Society of Anaesthesiology: lead

Study Sites (2)

University Hospital Knappschaftskrankenhaus Bochum

Bochum, Germany

Location

Wilhelmina Hospital Assen

Assen, Netherlands

Location

Related Publications (11)

• Moonesinghe SR, Wong DJN, Farmer L, Shawyer R, Myles PS, Harris SK; SNAP-2 Project team and Steering Group. SNAP-2 EPICCS: the second Sprint National Anaesthesia Project-EPIdemiology of Critical Care after Surgery: protocol for an international observational cohort study. BMJ Open. 2017 Sep 7;7(9):e017690. doi: 10.1136/bmjopen-2017-017690.

  PMID: 28882925 BACKGROUND

• Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries. Br J Anaesth. 2017 Sep 1;119(3):553. doi: 10.1093/bja/aew472. No abstract available.

  PMID: 28498884 BACKGROUND

• Kho ME, Duffett M, Willison DJ, Cook DJ, Brouwers MC. Written informed consent and selection bias in observational studies using medical records: systematic review. BMJ. 2009 Mar 12;338:b866. doi: 10.1136/bmj.b866.

  PMID: 19282440 BACKGROUND

• Biccard BM, Madiba TE, Kluyts HL, Munlemvo DM, Madzimbamuto FD, Basenero A, Gordon CS, Youssouf C, Rakotoarison SR, Gobin V, Samateh AL, Sani CM, Omigbodun AO, Amanor-Boadu SD, Tumukunde JT, Esterhuizen TM, Manach YL, Forget P, Elkhogia AM, Mehyaoui RM, Zoumeno E, Ndayisaba G, Ndasi H, Ndonga AKN, Ngumi ZWW, Patel UP, Ashebir DZ, Antwi-Kusi AAK, Mbwele B, Sama HD, Elfiky M, Fawzy MA, Pearse RM; African Surgical Outcomes Study (ASOS) investigators. Perioperative patient outcomes in the African Surgical Outcomes Study: a 7-day prospective observational cohort study. Lancet. 2018 Apr 21;391(10130):1589-1598. doi: 10.1016/S0140-6736(18)30001-1. Epub 2018 Jan 3.

  PMID: 29306587 BACKGROUND

• Pearse RM, Moreno RP, Bauer P, Pelosi P, Metnitz P, Spies C, Vallet B, Vincent JL, Hoeft A, Rhodes A; European Surgical Outcomes Study (EuSOS) group for the Trials groups of the European Society of Intensive Care Medicine and the European Society of Anaesthesiology. Mortality after surgery in Europe: a 7 day cohort study. Lancet. 2012 Sep 22;380(9847):1059-65. doi: 10.1016/S0140-6736(12)61148-9.

  PMID: 22998715 BACKGROUND

• Lambden S, Creagh-Brown BC, Hunt J, Summers C, Forni LG. Definitions and pathophysiology of vasoplegic shock. Crit Care. 2018 Jul 6;22(1):174. doi: 10.1186/s13054-018-2102-1.

  PMID: 29980217 BACKGROUND

• Hajjar LA, Vincent JL, Barbosa Gomes Galas FR, Rhodes A, Landoni G, Osawa EA, Melo RR, Sundin MR, Grande SM, Gaiotto FA, Pomerantzeff PM, Dallan LO, Franco RA, Nakamura RE, Lisboa LA, de Almeida JP, Gerent AM, Souza DH, Gaiane MA, Fukushima JT, Park CL, Zambolim C, Rocha Ferreira GS, Strabelli TM, Fernandes FL, Camara L, Zeferino S, Santos VG, Piccioni MA, Jatene FB, Costa Auler JO Jr, Filho RK. Vasopressin versus Norepinephrine in Patients with Vasoplegic Shock after Cardiac Surgery: The VANCS Randomized Controlled Trial. Anesthesiology. 2017 Jan;126(1):85-93. doi: 10.1097/ALN.0000000000001434.

  PMID: 27841822 BACKGROUND

• Abbott TEF, Fowler AJ, Pelosi P, Gama de Abreu M, Moller AM, Canet J, Creagh-Brown B, Mythen M, Gin T, Lalu MM, Futier E, Grocott MP, Schultz MJ, Pearse RM; StEP-COMPAC Group. A systematic review and consensus definitions for standardised end-points in perioperative medicine: pulmonary complications. Br J Anaesth. 2018 May;120(5):1066-1079. doi: 10.1016/j.bja.2018.02.007. Epub 2018 Mar 27.

  PMID: 29661384 BACKGROUND

• Jammer I, Wickboldt N, Sander M, Smith A, Schultz MJ, Pelosi P, Leva B, Rhodes A, Hoeft A, Walder B, Chew MS, Pearse RM; European Society of Anaesthesiology (ESA) and the European Society of Intensive Care Medicine (ESICM); European Society of Anaesthesiology; European Society of Intensive Care Medicine. Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine: European Perioperative Clinical Outcome (EPCO) definitions: a statement from the ESA-ESICM joint taskforce on perioperative outcome measures. Eur J Anaesthesiol. 2015 Feb;32(2):88-105. doi: 10.1097/EJA.0000000000000118.

  PMID: 25058504 BACKGROUND

• Jammer I, Martin P, Wunsch H, Debouche S, Harlet P, Moonesinghe R, Forni L, Creagh-Brown B; Writing committee for the Squeeze investigators. Vasopressor use after noncardiac surgery: an international observational study. Br J Anaesth. 2025 Dec;135(6):1609-1617. doi: 10.1016/j.bja.2025.07.034. Epub 2025 Aug 11.

  PMID: 40796492 DERIVED

• Creagh-Brown B, Wunsch H, Martin P, Harlet P, Forni L, Moonesinghe SR, Jammer I. The incidence of postoperative vasopressor usage: protocol for a prospective international observational cohort study (SQUEEZE). Perioper Med (Lond). 2023 Mar 24;12(1):8. doi: 10.1186/s13741-023-00296-1.

  PMID: 36964590 DERIVED

Related Links

• ESAIC Clinical Trial Network website

Study Officials

• Ib Jammer, Dr

  Haukeland University Hospital

  STUDY CHAIR

• Ben Creagh-Brown

  Royal Surrey County Hospital NHS Foundation Trust

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 14, 2019
• First Posted: January 15, 2019
• Study Start: October 5, 2020
• Primary Completion: October 1, 2023
• Study Completion: March 31, 2024
• Last Updated: April 10, 2024

Record last verified: 2024-04

Data Sharing

• IPD Sharing: Will not share

Locations

NL (1); DE (1)