<< Back to News

3/17/25 New Sentri7 Rule

March 17, 2025

Good afternoon pharmacists,

I just wanted to reach out and update you on a new Sentri7 rule that is going LIVE today.

As part of my major project, I'm assessing the timing of vasopressin initiation on outcomes for patients being treated for septic shock already on appropriate norepinephrine therapy. The Surviving Sepsis guidelines recommend the use of norepinephrine as the first line vasopressor for hemodynamic pressure support. And if the mean arterial pressure cannot be maintained above 65 with a low-moderate dose of norepinephrine (defined as 0.25-0.5 mcg/kg/min), vasopressin is recommended to be added on instead of increasing the norepinephrine dose.

So far for the patients I have reviewed, approximately 60% of the time we are not adding vasopressin until the norepinephrine dose is >0.5 mcg/kg/min. We will be adding an order comment on all norepinephrine orders stating, "For patients with septic shock, consider the addition of vasopressin when the norepinephrine dose is > 0.25 mcg/kg/min."

Additionally, to help identify these patients a new Sentri7 rule has been created. This is listed under the Critical Alert tab. This rule only applies to patients diagnosed with septic shock, for those being treated for another indication, you can review NEVER.

I will be presenting this at Huddle on Monday, March 24^th. Please let me know if you have any questions or suggestions on this process!

Thank you,

Trish Elder, PharmD
PGY-2 Critical Care Pharmacy Resident
Huntsville Hospital
101 Sivley Rd., Huntsville, AL 35801
(256) 265-6213