Evidence map›Paper›PMID 31797234›Full record

GuidelineCanadian journal of anaesthesia = Journal canadien d'anesthesie2020

Canadian Critical Care Society clinical practice guideline: The use of vasopressin and vasopressin analogues in critically ill adults with distributive shock.

Kimia Honarmand, Kevin John Um, Emilie P Belley-Côté, Waleed Alhazzani, Chris Farley, Shannon M Fernando, Kirsten Fiest, Donna Grey, Edita Hajdini, Margaret Herridge and 11 more

Open access · bronzeAbstract readPractice GuidelineSystematic Review
PubMed Publisher
In one paragraph

Guideline in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 pooled it
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Observational
  4. Article
  5. Review
  6. [Distributive shock].Die Anaesthesiologie · 2023
    Article
  7. Article
  8. Review
  9. Article
  10. Review
  11. Basic Critical Care for Management of COVID-19 Patients: Position Paper of the Indian Society of Critical Care Medicine, Part II.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2020
    Review
  12. Article
  13. Review
  14. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 16 institutions in 2 countries.

Kimia HonarmandDivision of Critical Care, Department of Medicine, Western University, London, ON, Canada.
Kevin John UmDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Emilie P Belley-CôtéDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Waleed AlhazzaniDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Chris FarleyHamilton Health Sciences Centre, Hamilton, ON, Canada.
Shannon M FernandoDivision of Critical Care, Department of Medicine and Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
Kirsten FiestDepartment of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Donna GreySchool of Nursing, McMaster University, Hamilton, ON, Canada.
Edita HajdiniSchool of Nursing, McMaster University, Hamilton, ON, Canada.
Margaret HerridgeDepartment of Medicine, Toronto General Hospital/University Health Network, and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Carmen HrymakSection of Critical Care, Department of Medicine, and Department of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada.
Morten Hylander MøllerDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Denmark.
Salmaan KanjiDepartment of Pharmacy, The Ottawa Hospital and Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
François LamontagneDepartment of Medicine, Université de Sherbrooke and Centre de recherche du CHU de Sherbrooke, Sherbrooke, QC, Canada.
François LauzierDepartment of Medicine and Department of Anesthesiology & Critical Care and Trauma - Emergency - Critical Care Medicine, Population Health and Optimal Health Practices Research Unit, CHU de Québec, Université Laval Research Centre, Université Laval, Quebec, QC, Canada.
Sangeeta MehtaDepartment of Medicine, Sinai Health System and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Bojan PaunovicDepartment of Internal Medicine, Section of Critical Care, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Rohit SingalCVT Associates, Vancouver Island Health Authority, Victoria, BC, Canada.
Jennifer Ly TsangDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Christine WynneHamilton Health Sciences Centre, Hamilton, ON, Canada.
Bram RochwergDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada. rochwerg@mcmaster.ca.ORCID http://orcid.org/0000-0002-8293-7061
McMaster University · CAHealth Sciences Centre · CAUniversity of Manitoba · CACopenhagen University Hospital · DKImpact · CAIsland Health · CAJuravinski Hospital · CANiagara College · CAOttawa Hospital · CAUniversité de Sherbrooke · CAUniversité Laval · CAUniversity Health Network · CAUniversity of Calgary · CAUniversity of Ottawa · CAUniversity of Toronto · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeHemodynamic management of adults with distributive shock often includes the use of catecholamine-based vasoconstricting medications. It is unclear whether adding vasopressin or vasopressin analogues to catecholamine therapy is beneficial in the management of patients with distributive shock. The purpose of this guideline was to develop an evidence-based recommendation regarding the addition of vasopressin to catecholamine vasopressors in the management of adults with distributive shock.

methodsWe summarized the evidence informing this recommendation by updating a recently published meta-analysis. Then, a multidisciplinary panel from the Canadian Critical Care Society developed the recommendation using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology.

resultsThe updated systematic review identified 25 randomized controlled trials including a total of 3,737 patients with distributive shock. Compared with catecholamine therapy alone, the addition of vasopressin or its analogues was associated with a reduced risk of mortality (relative risk [RR], 0.91; 95% confidence interval [CI], 0.85 to 0.99; low certainty), reduced risk of atrial fibrillation (RR, 0.77; 95% CI, 0.67 to 0.88; high certainty), and increased risk of digital ischemia (RR, 2.56; 95% CI, 1.24 to 5.25; moderate certainty).

conclusionsAfter considering certainty in the evidence, values and preferences, cost, and other factors, the expert guideline panel suggests using vasopressin or vasopressin analogues in addition to catecholamines over catecholamine vasopressors alone for the management of distributive shock (conditional recommendation, low certainty evidence).

Indexed as

Critical IllnessShockVasopressinsAdultCanadaCritical CareHumansVasopressins

Identifiers

PMID31797234
OpenAlexW2994116020

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.