Evidence map›Paper›PMID 33251906›Full record

ArticleJournal of intensive care medicine2022

Hemodynamic Response to Vasopressin Dosage of 0.03 Units/Min vs. 0.04 Units/Min in Patients With Septic Shock.

Seth R Bauer, Gretchen L Sacha, Simon W Lam, Lu Wang, Anita J Reddy, Abhijit Duggal, Vidula Vachharajani

Abstract read
In one paragraph

Article in Journal of intensive care medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
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

7 citing papers in PubMed.

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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

7 authors.

Seth R BauerDepartment of Pharmacy, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0002-0420-0320
Gretchen L SachaDepartment of Pharmacy, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0002-0070-8100
Simon W LamDepartment of Pharmacy, Cleveland Clinic, Cleveland, OH, USA.
Lu WangDepartment of Pharmacy, Cleveland Clinic, Cleveland, OH, USA.
Anita J ReddyDepartment of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA.
Abhijit DuggalDepartment of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA.
Vidula VachharajaniDepartment of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA.

Funding

Bioenergetic and Epigenetic Reprogramming by Obesity in SepsisR01GM099807 · NIGMS · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI VACHHARAJANI, VIDULA · 2012 to 2020
$3.1M
NIGMS NIH HHS R01 GM099807
6 · The paper itself

Abstract

backgroundArginine vasopressin (AVP) is suggested as an adjunct to norepinephrine in patients with septic shock. Guidelines recommend an AVP dosage up to 0.03 units/min, but 0.04 units/min is commonly used in practice based on initial studies. This study was designed to compare the incidence of hemodynamic response between initial fixed-dosage AVP 0.03 units/min and AVP 0.04 units/min.

methodsThis retrospective, multi-hospital health system, cohort study included adult patients with septic shock receiving AVP as an adjunct to catecholamine vasopressors. Patients were excluded if they received an initial dosage other than 0.03 units/min or 0.04 units/min, or AVP was titrated within the first 6 hours of therapy. The primary outcome was hemodynamic response, defined as a mean arterial pressure ≥65 mm Hg and a decrease in catecholamine dosage at 6 hours after AVP initiation. Inverse probability of treatment weighting (IPTW) based on the propensity score for initial AVP dosage receipt was utilized to estimate adjusted exposure effects.

resultsOf the 1536 patients included in the observed data, there was a nearly even split between initial AVP dosage of 0.03 units/min (n = 842 [54.8%]) and 0.04 units/min (n = 694 [45.2%]). Observed patients receiving AVP 0.03 units/min were more frequently treated at the main campus academic medical center (96.3% vs. 52.2%, p < 0.01) and in a medical intensive care unit (87.4% vs. 39.8%, p < 0.01). The IPTW analysis included 1379 patients with achievement of baseline covariate balance. There was no evidence for a difference between groups in the incidence of hemodynamic response (0.03 units/min 50.0% vs. 0.04 units/min 53.1%, adjusted relative risk 1.06 [95% CI 0.94, 1.20]).

conclusionsInitial AVP dosing varied by hospital and unit type. Although commonly used, an initial AVP dosage of 0.04 units/min was not associated with a higher incidence of early hemodynamic response to AVP in patients with septic shock.

Indexed as

Shock, SepticVasoconstrictor AgentsVasopressinsAdultHemodynamicsHumansRetrospective StudiesVasoconstrictor AgentsVasopressinshemodynamicsnorepinephrinesepsissepticshockvasoconstrictor agentsvasopressins

Identifiers

PMID33251906
PMCPMC10243460

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Registered trials

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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.