• Hye Ju Yeo, Young Seok Lee, Tae Hwa Kim, Jin Ho Jang, Heung Bum Lee, Dong Kyu Oh, Mi Hyeon Park, Chae-Man Lim, Woo Hyun Cho, and Korean Sepsis Alliance (KSA) Investigators.
• Division of Allergy, Pulmonary and Critical care medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
• Crit. Care Med. 2022 Apr 1; 50 (4): e351e360e351-e360.

ObjectivesTo investigate whether administration of a vasopressor within 1 hour of first fluid loading affected mortality and organ dysfunction in septic shock patients.DesignProspective, multicenter, observational study.SettingSixteen tertiary or university hospitals in the Republic of Korea.PatientsPatients with septic shock (n = 415) were classified into early and late groups according to whether the vasopressor was initiated within 1 hour of the first resuscitative fluid load. Early (n = 149) patients were 1:1 propensity matched to late (n = 149) patients.InterventionsNone.Measurement And Main ResultsThe median time from the initial fluid bolus to vasopressor was shorter in the early group (0.3 vs 2.3 hr). There was no significant difference in the fluid bolus volume within 6 hours (33.2 vs 35.9 mL/kg) between the groups. The Sequential Organ Failure Assessment score and lactate level on day 3 in the ICU were significantly higher in the early group than that in the late group (Sequential Organ Failure Assessment, 9.2 vs 7.7; lactate level, 2.8 vs 1.7 mmol/L). In multivariate Cox regression analyses, early vasopressor use was associated with a significant increase in the risk of 28-day mortality (hazard ratio, 1.83; 95% CI, 1.26-2.65).ConclusionsVasopressor initiation within 1 hour of fluid loading was associated with higher 28-day mortality in patients with septic shock.Copyright © 2022 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

8 keywords...

hide…