SynthesisPloS one2015
Non-Adrenergic Vasopressors in Patients with or at Risk for Vasodilatory Shock. A Systematic Review and Meta-Analysis of Randomized Trials.
Synthesis in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06934798 (Inotropic Effects of Vasopressin Versus Noradrenaline In Patients With Vasoplegic Syndrome After Cardiac Surgery), which is not on this map. Cited by 23 papers, 5 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.
Inotropic Effects of Vasopressin Versus Noradrenaline In Patients With Vasoplegic Syndrome After Cardiac Surgery
Who cites it
23 citing papers in PubMed, 5 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- The effects of vasopressor choice on renal outcomes in septic shock: a systematic review of randomised trials as a guide for future research.Critical care (London, England) · 2025Pooled it
- Non-adrenergic vasopressors for vasodilatory shock or perioperative vasoplegia: a meta-analysis of randomized controlled trials.Critical care (London, England) · 2024Pooled it
- Methylene blue in sepsis and septic shock: a systematic review and meta-analysis.Frontiers in medicine · 2024Pooled it
- The effects and safety of vasopressin receptor agonists in patients with septic shock: a meta-analysis and trial sequential analysis.Critical care (London, England) · 2019Pooled it
- Pooled it
- Adjunctive terlipressin versus placebo in the treatment of refractory septic shock: a randomized, placebo-controlled trial.Critical care (London, England) · 2025Trial
- Microcirculation improvement after short-term infusion of vasopressin in septic shock is dependent on noradrenaline.Clinics (Sao Paulo, Brazil) · 2017Trial
- Timing and dose do not tell the same story: a reply to Wieruszewski and Khanna.Critical care (London, England) · 2026Article
- Pathophysiology and Perioperative Considerations for Heart Failure Patients.Life (Basel, Switzerland) · 2026Review
- Article
- Hydroxocobalamin for vasoplegia in cardiac surgery: a retrospective cohort analysis.British journal of anaesthesia · 2025Article
- Fifty shades of green and blue: autopsy findings after administration of xenobiotics.Forensic science, medicine, and pathology · 2025Review
- Management of Sepsis and Septic Shock: What Have We Learned in the Last Two Decades?Microorganisms · 2023Review
- Review
- Vasopressor-Sparing Action of Methylene Blue in Severe Sepsis and Shock: A Narrative Review.Advances in therapy · 2020Review
- Extended Continuous Infusion of Methylene Blue for Refractory Septic Shock.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2020Article
- Methylene blue administration in patients with refractory distributive shock - a retrospective study.Scientific reports · 2020Article
- Less is more: catecholamine-sparing strategies in septic shock.Intensive care medicine · 2019Article
- A Potential Mechanism for Immune Suppression by Beta-Adrenergic Receptor Stimulation following Traumatic Injury.Journal of innate immunity · 2018Article
- Vasopressor hormones in shock-noradrenaline, vasopressin or angiotensin II: which one will make the race?Journal of thoracic disease · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHypotensive state is frequently observed in several critical conditions. If an adequate mean arterial pressure is not promptly restored, insufficient tissue perfusion and organ dysfunction may develop. Fluids and catecholamines are the cornerstone of critical hypotensive states management. Catecholamines side effects such as increased myocardial oxygen consumption and development of arrhythmias are well known. Thus, in recent years, interest in catecholamine-sparing agents such as vasopressin, terlipressin and methylene blue has increased; however, few randomized trials, mostly with small sample sizes, have been performed. We therefore conducted a meta-analysis of randomized trials to investigate the effect of non-catecholaminergic vasopressors on mortality.
methodsPubMed, BioMed Central and Embase were searched (update December 31st, 2014) by two independent investigators. Inclusion criteria were: random allocation to treatment, at least one group receiving a non-catecholaminergic vasopressor, patients with or at risk for vasodilatory shock. Exclusion criteria were: crossover studies, pediatric population, non-human studies, studies published as abstract only, lack of data on mortality. Studied drugs were vasopressin, terlipressin and methylene blue. Primary endpoint was mortality at the longest follow-up available.
resultsA total of 1,608 patients from 20 studies were included in our analysis. The studied settings were sepsis (10/20 studies [50%]), cardiac surgery (7/20 [35%]), vasodilatory shock due to any cause (2/20 [19%]), and acute traumatic injury (1/20 [5%]). Overall, pooled estimates showed that treatment with non-catecholaminergic agents improves survival (278/810 [34.3%] versus 309/798 [38.7%], risk ratio = 0.88, 95% confidence interval = 0.79 to 0.98, p = 0.02). None of the drugs was associated with significant reduction in mortality when analyzed independently. Results were not confirmed when analyzing studies with a low risk of bias.
conclusionsCatecholamine-sparing agents in patients with or at risk for vasodilatory shock may improve survival. Further researches on this topic are needed to confirm the finding.
Indexed as
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.