Efficacy and Safety of the Early Addition of Vasopressin to Norepinephrine in Septic Shock.


Journal

Journal of intensive care medicine
ISSN: 1525-1489
Titre abrégé: J Intensive Care Med
Pays: United States
ID NLM: 8610344

Informations de publication

Date de publication:
Historique:
pubmed: 19 8 2017
medline: 12 9 2020
entrez: 19 8 2017
Statut: ppublish

Résumé

Delays in achievement of target mean arterial pressure (MAP) have been associated with increased mortality in patients with septic shock. Vasopressin may be added to norepinephrine to raise MAP or decrease norepinephrine dosage. The purpose of this study was to determine whether early initiation of vasopressin to norepinephrine resulted in a reduced time to target MAP compared to norepinephrine monotherapy. This retrospective cohort study compared early addition of vasopressin within 4 hours of septic shock onset to norepinephrine versus initial norepinephrine monotherapy in medically, critically ill patients with septic shock admitted from May 2014 to October 2015. Time to goal MAP was compared using Student Each group contained 48 patients. Mean arterial pressure (61.5 vs 58.6 mm Hg) and intravenous fluid volume received at vasopressor initiation (14.3 vs 25.2 hours, Early initiation of vasopressin in patients with septic shock may achieve and maintain goal MAP sooner and resolve organ dysfunction at 72 hours more effectively than later or no initiation.

Sections du résumé

BACKGROUND BACKGROUND
Delays in achievement of target mean arterial pressure (MAP) have been associated with increased mortality in patients with septic shock. Vasopressin may be added to norepinephrine to raise MAP or decrease norepinephrine dosage. The purpose of this study was to determine whether early initiation of vasopressin to norepinephrine resulted in a reduced time to target MAP compared to norepinephrine monotherapy.
METHODS METHODS
This retrospective cohort study compared early addition of vasopressin within 4 hours of septic shock onset to norepinephrine versus initial norepinephrine monotherapy in medically, critically ill patients with septic shock admitted from May 2014 to October 2015. Time to goal MAP was compared using Student
RESULTS RESULTS
Each group contained 48 patients. Mean arterial pressure (61.5 vs 58.6 mm Hg) and intravenous fluid volume received at vasopressor initiation (14.3 vs 25.2 hours,
CONCLUSION CONCLUSIONS
Early initiation of vasopressin in patients with septic shock may achieve and maintain goal MAP sooner and resolve organ dysfunction at 72 hours more effectively than later or no initiation.

Identifiants

pubmed: 28820036
doi: 10.1177/0885066617725255
doi:

Substances chimiques

Vasoconstrictor Agents 0
Vasopressins 11000-17-2
Norepinephrine X4W3ENH1CV

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

910-916

Auteurs

Drayton A Hammond (DA)

University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR, USA.
University of Arkansas for Medical Sciences Medical Center, Little Rock, AR, USA.

Julia Cullen (J)

University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR, USA.

Jacob T Painter (JT)

University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR, USA.

Kelsey McCain (K)

University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR, USA.

Oktawia A Clem (OA)

University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR, USA.

Amy L Brotherton (AL)

Grady Health System, Atlanta, GA, USA.

Divyan Chopra (D)

University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR, USA.

Nikhil Meena (N)

University of Arkansas for Medical Sciences Medical Center, Little Rock, AR, USA.
University of Arkansas for Medical Sciences College of Medicine, Little Rock, AR, USA.

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Classifications MeSH