ArticleAnnals of intensive care2017
Outcome of patients with septic shock and high-dose vasopressor therapy.
Article in Annals of intensive care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07453901 (The Multicentre Prospective Observational Study on the Management of Septic Shock), which is not on this map. Cited by 76 papers, 3 of them syntheses that pooled it.
What it found
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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.
The Multicentre Prospective Observational Study on the Management of Septic Shock (Observational Study on Septic Shock, the OSS Study)
Who cites it
76 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Association of noradrenaline dose with mortality in critically ill patients: a systematic review and dose-response meta-analysis.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
- Vasoactive agents in acute mesenteric ischaemia in critical care. A systematic review.F1000Research · 2021Pooled it
- Adjunctive terlipressin versus placebo in the treatment of refractory septic shock: a randomized, placebo-controlled trial.Critical care (London, England) · 2025Trial
- Effects of Esketamine Versus Remifentanil on Hemodynamics and Prognosis in Patients with Septic Shock Receiving Invasive Mechanical Ventilation: A Randomized Controlled Trial.Drug design, development and therapy · 2025Trial
- Effects of dynamic versus static parameter-guided fluid resuscitation in patients with sepsis: A randomized controlled trial.F1000Research · 2024Trial
- Early adjunctive methylene blue in patients with septic shock: a randomized controlled trial.Critical care (London, England) · 2023Trial
- Role of Angiotensin II as a Vasoactive Agent to Treat Distributive Shock With a Focus on Preliminary Data in Pediatric-Aged Patients.Paediatric anaesthesia · 2026Review
- A hybrid multi-criteria decision-making framework for prioritising clinical determinants of medical futility in the intensive care unit.Journal of intensive care · 2026Article
- Severe Burn Injury Alters Expression of Adrenergic Receptor Transcripts in a Rodent Model.European burn journal · 2026Article
- Effect of Weight-based versus Absolute Norepinephrine Dosing on Mortality Risk in Obese Patients with Septic Shock: An Observational, Multicohort, Retrospective Study.Anesthesiology · 2026Observational
- The usual suspects: a pragmatic framework to identify and address reversible contributors in apparent refractory septic shock.Critical care (London, England) · 2026Review
- Noradrenaline-trajectory phenotypes in septic shock: derivation and external validation in two independent cohorts.Intensive care medicine experimental · 2026Article
- Relationship between norepinephrine dose and outcome in septic shock: a retrospective study.Journal of anesthesia, analgesia and critical care · 2026Article
- Clinical criteria for the definition of refractory septic shock: a joint Delphi consensus from the Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM).Intensive care medicine · 2026Article
- Refractory septic shock new definition: a first stone to pave a long way.Intensive care medicine · 2026Article
- Modulation of the Vasopressin System in Distributive and Cardiogenic Shock: Theoretical Principles and Practical Applications.Journal of clinical medicine · 2026Review
- Personalized sepsis mortality prediction: An interpretable machine learning nomogram.Clinics (Sao Paulo, Brazil) · 2026Article
- Association between time to target mean arterial pressure and 90-day mortality in septic shock: a post hoc analysis of the OPTPRESS trial.Annals of intensive care · 2026Article
- Machine Learning-Based Prediction of 28-Day Mortality in Patients with Sepsis-Induced Cardiomyopathy: An Integrated Analysis of Inflammatory Biomarkers.Journal of inflammation research · 2026Article
16 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite the dissemination of international guidelines, mortality from septic shock remains high. Norepinephrine is recommended as first-line vasopressor therapy with a target mean arterial pressure of 65 mmHg. High-dose vasopressor (HDV) may also be required. This study aimed to assess survival in patients with septic shock requiring HDV. We conducted a retrospective study of patients admitted between January 2008 and December 2013 to a 13-bed ICU for septic shock and receiving high-dose vasopressor therapy (defined by a dose >1 µg/kg/min). Primary outcome was 28-day mortality (D28). Secondary outcomes were 90-day mortality (D90), organ failure score (SOFA), duration of organ failure, duration and dosage of vasopressor agent and ischemic complications.
resultsIn our cohort of 106 patients, mortality reached 60.4% at D28 and 66.3% at D90. One in two patients died before D10. The weight-based mean dose of vasopressor (WMD) represented the best prognostic factor. Using a cutoff of 0.75 µg/kg/min, WMD was associated with mortality with a sensitivity of 73% and specificity of 74%. The mortality rate reached 86.4% when WMD was above the cutoff value and associated with a SOFA score >10. Digital or limb necrosis was documented in 6 patients (5.7%).
conclusionsIn total, 40% of septic shock patients receiving high-dose vasopressor therapy survived at day 28 after admission. A WMD cutoff value of 0.75 µg/kg/min, associated with a >10 SOFA score, was a strong predictor of death. These results provide insights into outcome of refractory septic shock, showing that administration of high-dose vasopressor may indeed be useful in these patients.
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