ReviewIntensive care medicine2019
Vasopressor therapy in critically ill patients with shock.
Review in Intensive care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 99 papers, 4 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
99 citing papers in PubMed, 4 syntheses or guidelines pooled it, 216 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
- Mortality, morbidity & clinical outcome with different types of vasopressors in out of hospital cardiac arrest patients- a systematic review and meta-analysis.BMC cardiovascular disorders · 2024Pooled it
- Methylene blue in sepsis and septic shock: a systematic review and meta-analysis.Frontiers in medicine · 2024Pooled it
- High-normal versus low-normal mean arterial pressure thresholds in critically ill patients: a systematic review and meta-analysis of randomized trials.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Pooled it
- Cardiogenic Shock Centers and Protocols for Acute Cardiovascular Care: Bridging the Gap Between Spoke and Hub Sites.Cardiology and therapy · 2026Review
- Visual prompt engineering for multimodal and irregularly sampled medical data.Communications medicine · 2026Article
- Alarm configuration and adherence to prescribed mean arterial pressure targets in the intensive care unit: A multicentre pre-post evaluation.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Noradrenaline-trajectory phenotypes in septic shock: derivation and external validation in two independent cohorts.Intensive care medicine experimental · 2026Article
- Radial versus femoral access for coronary angiography and percutaneous coronary interventions in critically ill patients.Journal of anesthesia, analgesia and critical care · 2026Article
- Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026.Intensive care medicine · 2026Article
- Comparison of Controller Logics for Automating Vasopressor Administration Using a Hardware-in-Loop Test Platform.Bioengineering (Basel, Switzerland) · 2026Article
- Intraoperative vasopressor use as a risk factor for early periprosthetic joint infection after total joint arthroplasty: A retrospective cohort study.Journal of orthopaedics · 2026Article
- The hemodynamics of tracheal intubation in critically ill patients: a narrative review.Journal of intensive care · 2026Review
- Assessing vascular tone and vascular responsiveness to norepinephrine: How simple tools can help?Journal of intensive medicine · 2026Article
- Comparison of vasopressin-first weaning versus norepinephrine-first weaning in critically ill patients.International journal of clinical pharmacology and therapeutics · 2026Article
- Respiratory Support in Cardiogenic Pulmonary Edema: Clinical Insights from Cardiology and Intensive Care.Journal of cardiovascular development and disease · 2026Review
- Elevated growth differentiation factor-15 in sepsis: clinical associations and immune cell context.Frontiers in cell and developmental biology · 2026Article
- Catecholamines and serum potassium alterations in critically ill neonates: a prospective cohort study.Critical care science · 2026Article
- Comparative Efficacy of Noradrenaline vs. Other Vasopressors on Outcomes in Patients With Cardiogenic Shock - A Systematic Review and Meta-Analysis.Circulation reports · 2025Article
- Vasopressin Improves Cerebral Perfusion Pressure but Not Cerebral Blood Flow or Tissue Oxygenation in Patients with Subarachnoid Hemorrhage and Norepinephrine-Refractory Hypotension: A Preliminary Evaluation.Journal of clinical medicine · 2025Article
39 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
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVasopressors are administered to critically ill patients with vasodilatory shock not responsive to volume resuscitation, and less often in cardiogenic shock, and hypovolemic shock.
objectivesThe objectives are to review safety and efficacy of vasopressors, pathophysiology, agents that decrease vasopressor dose, predictive biomarkers, β1-blockers, and directions for research.
methodsThe quality of evidence was evaluated using Grading of Recommendations Assessment, Development, and Evaluation (GRADE).
resultsVasopressors bind adrenergic: α1, α2, β1, β2; vasopressin: AVPR1a, AVPR1B, AVPR2; angiotensin II: AG1, AG2; and dopamine: DA1, DA2 receptors inducing vasoconstriction. Vasopressor choice and dose vary because of patients and physician practice. Adverse effects include excessive vasoconstriction, organ ischemia, hyperglycemia, hyperlactatemia, tachycardia, and tachyarrhythmias. No randomized controlled trials of vasopressors showed a significant difference in 28-day mortality rate. Norepinephrine is the first-choice vasopressor in vasodilatory shock after adequate volume resuscitation. Some strategies that decrease norepinephrine dose (vasopressin, angiotensin II) have not decreased 28-day mortality while corticosteroids have decreased 28-day mortality significantly in some (two large trials) but not all trials. In norepinephrine-refractory patients, vasopressin or epinephrine may be added. A new vasopressor, angiotensin II, may be useful in profoundly hypotensive patients. Dobutamine may be added because vasopressors may decrease ventricular contractility. Dopamine is recommended only in bradycardic patients. There are potent vasopressors with limited evidence (e.g. methylene blue, metaraminol) and novel vasopressors in development (selepressin).
conclusionsNorepinephrine is first choice followed by vasopressin or epinephrine. Angiotensin II and dopamine have limited indications. In future, predictive biomarkers may guide vasopressor selection and novel vasopressors may emerge.
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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.