• Crit Care Resusc · Dec 2024

    Timing of adjunctive vasopressin initiation for septic shock patients and hospital mortality: A multicentre observational study.

    • Kyle C White, Rahul Costa-Pinto, Anis Chaba, Philippa McIlroy, Siva Senthuran, Stephen Luke, Antony G Attokaran, Peter Garrett, Mahesh Ramanan, Alexis Tabah, Kiran Shekar, Kevin B Laupland, Hayden White, James McCullough, Andrew Udy, Glenn Eastwood, Rinaldo Bellomo, and Queensland Critical Care Research Network (QCCRN).
    • Intensive Care Unit, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane, QLD, 4102, Australia.
    • Crit Care Resusc. 2024 Dec 1; 26 (4): 295302295-302.

    ObjectiveThe optimal timing of vasopressin initiation as an adjunctive vasopressor remains unclear. We aimed to study the association between the timing of vasopressin commencement, pre-specified physiological parameters, and hospital mortality.DesignWe conducted a multicentre, retrospective, observational study.SettingTwelve ICUs in Queensland, Australia between January 2015 and December 2021.ParticipantsAdult patients with septic shock who received vasopressin as an adjunctive vasopressor within 72 hours of ICU admission.Main OutcomeHospital mortality.ResultsOverall, 2747 patients fulfilled the inclusion criteria. Of these, 1850 (67%) started vasopressin within six hours of vasopressor therapy start, while 897 (33%) started vasopressin between six hours and 72 hours. APACHE III score, peak lactate, and creatinine were higher in the early start group. Early vasopressin start was independently associated with decreased hospital mortality (aOR = 0.69, 95% CI = 0.57-0.83). Vasopressin infusion start was also associated with an immediate decrease in the noradrenaline-equivalent dose regardless of timing. There was a statistically significant favourable breakpoint at vasopressin start for the course of arterial pH, lactate, heart rate and crystalloid infusion rate (p<0.001).ConclusionsIn patients with septic shock, early adjunctive vasopressin initiation was independently associated with lower hospital mortality. Vasopressin starting at any time was also associated with reduced tachycardia, acidosis, and hyperlactatemia.© 2024 The Authors.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

Want more great medical articles?

Keep up to date with a free trial of metajournal, personalized for your practice.
1,694,794 articles already indexed!

We guarantee your privacy. Your email address will not be shared.