Calculate norepinephrine-equivalent dose for vasopressor comparison. Use for hemodynamic support quantification, shock severity assessment, or vasopressor weaning studies.
Calculates norepinephrine-equivalent dose (NED) to enable comparison across different vasopressor agents. Based on the Goradia et al. 2020 scoping review of vasopressor dose equivalence.
| Vasopressor | Equivalence Ratio | Comparison Dose | Units |
|---|---|---|---|
| Norepinephrine | 1:1 | 0.1 | mcg/kg/min |
| Epinephrine | 1:1 | 0.1 | mcg/kg/min |
| Dopamine | 1:100 | 10 |
| mcg/kg/min |
| Phenylephrine | 1:10 | 1 | mcg/kg/min |
| Vasopressin | 1:0.4* | 0.04 | units/min |
*Vasopressin is converted: vasopressin_units_per_hr * 2.5 / 60
SELECT
stay_id,
starttime,
endtime,
norepinephrine_equivalent_dose
FROM mimiciv_derived.norepinephrine_equivalent_dose;
norepinephrine_equivalent_dose = ROUND(
COALESCE(norepinephrine, 0)
+ COALESCE(epinephrine, 0)
+ COALESCE(phenylephrine / 10, 0)
+ COALESCE(dopamine / 100, 0)
+ COALESCE(vasopressin * 2.5 / 60, 0),
4
)
Individual vasopressor tables provide dose rates:
mimiciv_derived.norepinephrinemimiciv_derived.epinephrinemimiciv_derived.dopaminemimiciv_derived.phenylephrinemimiciv_derived.vasopressinAll consolidated in:
mimiciv_derived.vasoactive_agentWeight-Based Dosing: All doses are in mcg/kg/min (except vasopressin in units/hr). The underlying tables use patient weight for conversion.
Weight Estimation: When weight is not documented, it may be estimated. Check mimiciv_derived.weight_durations for weight source.
Vasopressin Units: Vasopressin is charted in units/hour, not units/min. The formula converts appropriately.
Excluded Agents:
Time Intervals: Each row has a starttime/endtime representing when that dose was active.
Multiple Simultaneous Agents: NED sums all concurrent vasopressors.
SELECT
stay_id,
MAX(norepinephrine_equivalent_dose) AS max_ned
FROM mimiciv_derived.norepinephrine_equivalent_dose
GROUP BY stay_id
ORDER BY max_ned DESC;
SELECT
stay_id,
SUM(TIMESTAMP_DIFF(endtime, starttime, HOUR)) AS vasopressor_hours
FROM mimiciv_derived.norepinephrine_equivalent_dose
WHERE norepinephrine_equivalent_dose > 0
GROUP BY stay_id;
WITH weighted AS (
SELECT
stay_id,
norepinephrine_equivalent_dose *
TIMESTAMP_DIFF(endtime, starttime, MINUTE) AS dose_minutes,
TIMESTAMP_DIFF(endtime, starttime, MINUTE) AS duration_minutes
FROM mimiciv_derived.norepinephrine_equivalent_dose
)
SELECT
stay_id,
SUM(dose_minutes) / NULLIF(SUM(duration_minutes), 0) AS time_weighted_ned
FROM weighted
GROUP BY stay_id;
WITH max_ned AS (
SELECT
stay_id,
MAX(norepinephrine_equivalent_dose) AS max_ned
FROM mimiciv_derived.norepinephrine_equivalent_dose
GROUP BY stay_id
)
SELECT
CASE
WHEN max_ned = 0 THEN 'No vasopressors'
WHEN max_ned < 0.1 THEN 'Low dose (<0.1)'
WHEN max_ned < 0.3 THEN 'Moderate (0.1-0.3)'
WHEN max_ned < 0.5 THEN 'High (0.3-0.5)'
ELSE 'Very high (>=0.5)'
END AS vasopressor_category,
COUNT(*) AS n_stays
FROM max_ned
GROUP BY 1
ORDER BY 1;