ArticleAnnals of intensive care2020
Potential risks in using midodrine for persistent hypotension after cardiac surgery: a comparative cohort study.
Article in Annals of intensive care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 20 citations in OpenAlex.
- Midodrine initiation criteria, dose titration, and adverse effects when administered to treat shock: A systematic review and semi-quantitative analysis.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2025Review
- Oral blood pressure augmenting agents for intravenous vasopressor weaning.World journal of clinical cases · 2024Review
- Midodrine for the early liberation from vasopressor support in the ICU (LIBERATE): a feasibility study.Pilot and feasibility studies · 2024Article
- Safety of midodrine in patients with heart failure with reduced ejection fraction: a retrospective cohort study.Frontiers in pharmacology · 2024Article
- Microvascular dysfunction following cardiopulmonary bypass plays a central role in postoperative organ dysfunction.Frontiers in medicine · 2023Review
- Article
- Midodrine - why don't you just work better?Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2022Article
- Midodrine use in critically ill patients: a narrative review.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2022Review
- Letter to the Editor: "Midodrine to liberate ICU patients from intravenous vasopressors: Another negative fixed-dose trial".Journal of critical care · 2022Article
- Midodrine administration during critical illness: fixed-dose or titrate to response?Intensive care medicine · 2021Article
- Impact of Adjuvant Use of Midodrine to Intravenous Vasopressors: A Systematic Review and Meta-Analysis.Critical care research and practice · 2021Review
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPersistent hypotension is a frequent complication after cardiac surgery with cardiopulmonary bypass (CPB). Midodrine, an orally administered alpha agonist, could potentially reduce intravenous vasopressor use and accelerate ICU discharge of otherwise stable patients. The main objective of this study was to explore the clinical impacts of administering midodrine in patients with persistent hypotension after CPB. Our hypothesis was that midodrine would safely accelerate ICU discharge and be associated with more days free from ICU at 30 days.
resultsWe performed a retrospective cohort study that included all consecutive patients having received midodrine while being on vasopressor support in the ICU within the first week after cardiac surgery with CPB, between January 2014 and January 2018 at the Montreal Heart Institute. A contemporary propensity score matched control group that included patients who presented similarly prolonged hypotension after cardiac surgery was formed. After matching, 74 pairs of patients (1:1) fulfilled inclusion criteria for the study and control groups. Midodrine use was associated with fewer days free from ICU (25.8 [23.7-27.1] vs 27.2 [25.9-28] days, p = 0.002), higher mortality (10 (13.5%) vs 1 (1.4%), p = 0.036) and longer ICU length of stay (99 [68-146] vs 68 [48-99] hours, p = 0.001). There was no difference in length of intravenous vasopressors (63 [40-87] vs 44 [26-66] hours, p = 0.052), rate of ICU readmission (6 (8.1%) vs 2 (2.7%), p = 0.092) and occurrence of severe kidney injury (11 (14.9%) vs 10 (13.5%) patients, p = 0.462) between groups.
conclusionThe administration of midodrine for sustained hypotension after cardiac surgery with CPB was associated with fewer days free from ICU and higher mortality. Routine prescription of midodrine to hasten ICU discharge after cardiac surgery should be used with caution until further prospective studies are conducted.
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