ReviewCritical care research and practice2013
Therapeutic strategies for high-dose vasopressor-dependent shock.
Review in Critical care research and practice, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 34 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluating in Cirrhotics With Refractory Vasoplegia the Effect of Methylene Blue in Sepsis: A Randomized Controlled Trial
Does Therapeutic Plasma Exchange Have A Role in Resistant Cytokine Storm State Of COVID-19 Infection?
Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 98 citations in OpenAlex.
- Terlipressin for the treatment of septic shock in adults: a systematic review and meta-analysis.BMC anesthesiology · 2020Pooled it
- Pooled it
- The usual suspects: a pragmatic framework to identify and address reversible contributors in apparent refractory septic shock.Critical care (London, England) · 2026Review
- A two-center comparison of the efficacy of methylene blue and hydroxocobalamin for the treatment of refractory shock.Perfusion · 2026Observational
- Evaluation of Ketamine's Impact on Vasopressor Requirements in Critically Ill Patients: A Retrospective Cohort Study.Hospital pharmacy · 2026Article
- The Effects of CytoSorb in Critically Ill Adult Patients on Vasopressor Support: A Systematic Review and Meta-Analysis.Life (Basel, Switzerland) · 2026Review
- Current and emerging therapeutic options for refractory septic shock: A systematic review.World journal of critical care medicine · 2025Article
- Improvements in Vasopressor Requirements With Venovenous Extracorporeal Membrane Oxygenation.CHEST critical care · 2025Article
- Article
- Article
- Effects of Early Initiation of Polymyxin B Hemoperfusion Therapy in Patients with Cancer with Refractory Septic Shock.Journal of clinical medicine · 2024Article
- Extracorporeal membrane oxygenation in adult patients with sepsis and septic shock: Why, how, when, and for whom.Journal of intensive medicine · 2024Review
- Effectiveness of Angiotensin II for Catecholamine Refractory Septic or Distributive Shock on Mortality: A Propensity Score Weighted Analysis of Real-World Experience in the Medical ICU.Critical care explorations · 2022Article
- An investigation to the prolonged requirement (>7 days) of vasopressors in cervical spinal cord injury patients-a retrospective analysis.Spinal cord series and cases · 2021Article
- First Evaluation of a New Dynamic Scoring System Intended to Support Prescription of Adjuvant CytoSorb Hemoadsorption Therapy in Patients with Septic Shock.Journal of clinical medicine · 2021Article
- Refractory gram-negative septic shock complicated by extended purpura fulminans and multiple organ failure in a 23-year-old puerpera -a case report.Korean journal of anesthesiology · 2021Article
- Fluid Resuscitation for Refractory Hypotension.Frontiers in veterinary science · 2021Review
- High-Dose Vasopressor Therapy for Pediatric Septic Shock: When Is Too Much?Journal of pediatric intensive care · 2020Article
- Comment on "Vasoplegic syndrome following cardiothoracic surgery-review of pathophysiology and update of treatment options".Critical care (London, England) · 2020Article
- Effect of Very Low-Dose Hydrocortisone on Shock Reversal in Patients With Septic Shock.Critical care explorations · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
There is no consensual definition of refractory shock. The use of more than 0.5 mcg/kg/min of norepinephrine or epinephrine to maintain target blood pressure is often used in clinical trials as a threshold. Nearly 6% of critically ill patients will develop refractory shock, which accounts for 18% of deaths in intensive care unit. Mortality rates are usually greater than 50%. The assessment of fluid responsiveness and cardiac function can help to guide therapy, and inotropes may be used if hypoperfusion signs persist after initial resuscitation. Arginine vasopressin is frequently used in refractory shock, although definite evidence to support this practice is still missing. Its associations with corticosteroids improved outcome in observational studies and are therefore promising alternatives. Other rescue therapies such as terlipressin, methylene blue, and high-volume isovolemic hemofiltration await more evidence before use in routine practice.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.