SynthesisIntensive care medicine2018
Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients.
Synthesis in Intensive care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 60 papers, 3 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
60 citing papers in PubMed, 3 syntheses or guidelines pooled it, 178 citations in OpenAlex.
- [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- The association of vasoactive-inotropic score and surgical patients' outcomes: a systematic review and meta-analysis.Systematic reviews · 2024Pooled it
- Inotropic agents and vasodilator strategies for the treatment of cardiogenic shock or low cardiac output syndrome.The Cochrane database of systematic reviews · 2020Pooled it
- [Vasopressors in septic shock: the old and the new].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Review
- Cardiogenic Shock Centers and Protocols for Acute Cardiovascular Care: Bridging the Gap Between Spoke and Hub Sites.Cardiology and therapy · 2026Review
- Effects of septic shock vasopressors on the fitness of Escherichia coli.Scientific reports · 2026Article
- Novel treatment strategies in cardiogenic shock: an update on ongoing clinical trials.Heart failure reviews · 2026Review
- Comparison of the Hemodynamic Effects of Epinephrine on Blood Pressure Augmentation at 1-, 3-, and 5-Minute Dosing Intervals.Journal of the American Heart Association · 2026Article
- Assessment of the vasoactive-inotropic score in prognostic evaluation of critical patients following noncardiac surgery: a retrospective, observational study.BMC anesthesiology · 2026Observational
- Current standard of care for septic shock.Intensive care medicine · 2026Review
- Lactate in cardiogenic shock: pathophysiology, prognostic value, and clinical interpretation.Annals of intensive care · 2026Review
- Renal Dysfunction Across the Spectrum of Cardiogenic Shock: Mechanisms, Clinical Implications, and Therapeutic Strategies.Current heart failure reports · 2025Review
- A Comparison of Different Guidelines for the Treatment of Acute Heart Failure and Their Extensibility to Emergency Departments: A Critical Reappraisal.Journal of clinical medicine · 2025Review
- The current use of vasoactive agents in cardiogenic shock related to myocardial infarction and acute decompensated heart failure.American heart journal plus : cardiology research and practice · 2025Article
- Chinese Guidelines for the Diagnosis and Treatment of Heart Failure 2024.Journal of geriatric cardiology : JGC · 2025Article
- Sepsis-induced cardiogenic shock: controversies and evidence gaps in diagnosis and management.Journal of intensive care · 2025Review
- [Initial diagnosis and treatment of shock].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Article
- Hemodynamic management of cardiogenic shock in the intensive care unit.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2024Review
- Management of cardiogenic shock: a narrative review.Annals of intensive care · 2024Review
- Survival prediction for heart failure complicated by sepsis: based on machine learning methods.Frontiers in medicine · 2024Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
27 authors at 20 institutions in 12 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveCatecholamines have been the mainstay of pharmacological treatment of cardiogenic shock (CS). Recently, use of epinephrine has been associated with detrimental outcomes. In the present study we aimed to evaluate the association between epinephrine use and short-term mortality in all-cause CS patients.
designWe performed a meta-analysis of individual data with prespecified inclusion criteria: (1) patients in non-surgical CS treated with inotropes and/or vasopressors and (2) at least 15% of patients treated with epinephrine administrated alone or in association with other inotropes/vasopressors. The primary outcome was short-term mortality. MEASUREMENTS AND
resultsFourteen published cohorts and two unpublished data sets were included. We studied 2583 patients. Across all cohorts of patients, the incidence of epinephrine use was 37% (17-76%) and short-term mortality rate was 49% (21-69%). A positive correlation was found between percentages of epinephrine use and short-term mortality in the CS cohort. The risk of death was higher in epinephrine-treated CS patients (OR [CI] = 3.3 [2.8-3.9]) compared to patients treated with other drug regimens. Adjusted mortality risk remained striking in epinephrine-treated patients (n = 1227) (adjusted OR = 4.7 [3.4-6.4]). After propensity score matching, two sets of 338 matched patients were identified and epinephrine use remained associated with a strong detrimental impact on short-term mortality (OR = 4.2 [3.0-6.0]).
conclusionsIn this very large cohort, epinephrine use for hemodynamic management of CS patients is associated with a threefold increase of risk of death.
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.