ReviewCritical care (London, England)2023
An updated "norepinephrine equivalent" score in intensive care as a marker of shock severity.
Review in Critical care (London, England), 2023. 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 92 papers, 1 of them a synthesis 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
92 citing papers in PubMed, 1 synthesis or guideline pooled it, 138 citations in OpenAlex.
- Non-adrenergic vasopressors for vasodilatory shock or perioperative vasoplegia: a meta-analysis of randomized controlled trials.Critical care (London, England) · 2024Pooled it
- Early multimodal vasopressor strategy in septic shock: results of the TRICYCLE randomized controlled trial.Critical care (London, England) · 2026Trial
- Mechanical power guided lung protective ventilation in acute respiratory failure using the VentCoach approach.Scientific reports · 2026Trial
- Adjunctive terlipressin versus placebo in the treatment of refractory septic shock: a randomized, placebo-controlled trial.Critical care (London, England) · 2025Trial
- Hydrocortisone and Risk Factors for Kidney Replacement Therapy in Septic Shock.JAMA network open · 2025Trial
- Early adjunctive methylene blue in patients with septic shock: a randomized controlled trial.Critical care (London, England) · 2023Trial
- Bedside monitoring of the vascular response to norepinephrine in early septic shock: VNERi trajectories and comparison with dynamic clinical measures.Journal of clinical monitoring and computing · 2026Article
- Response to Dobutamine in Septic Shock With Myocardial Dysfunction: A Single-Center Retrospective Study.Critical care explorations · 2026Article
- Impact of different extracorporeal blood purification strategies during continuous renal replacement therapy in septic shock patients.Journal of intensive medicine · 2026Article
- Effect of Weight-based versus Absolute Norepinephrine Dosing on Mortality Risk in Obese Patients with Septic Shock: An Observational, Multicohort, Retrospective Study.Anesthesiology · 2026Observational
- In silico and in vitro exploration of a tyrosinase for biocatalytic production of catechols.FEBS open bio · 2026Article
- The usual suspects: a pragmatic framework to identify and address reversible contributors in apparent refractory septic shock.Critical care (London, England) · 2026Review
- Vasopressor Dosing Trajectories in Septic Shock According to Initial Antimicrobial Susceptibility and Infection Source Concordance: A Retrospective Observational Study.Medical sciences (Basel, Switzerland) · 2026Observational
- Dexmedetomidine in The Treatment of Toxicologic Conditions in The Emergency Department: A Dual-Center Retrospective Observational Cohort Study.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2026Observational
- Prone Positioning in a North American Cohort of Hypoxemic Patients on Mechanical Ventilation.Critical care medicine · 2026Observational
- Article
- Steroid administration, timing, and dose in patients with septic shock in the emergency department: retrospective analysis of a multicenter prospective cohort study.Scientific reports · 2026Observational
- High vasopressor doses are associated with decreased tissue oxygenation in critically ill patients: a secondary analysis of a prospective cohort.Critical care (London, England) · 2026Article
- Intraoperative lactate as an early risk marker in laparoscopic liver resection and its association with modifiable hemodynamic parameters: a retrospective cohort study.Journal of anesthesia · 2026Article
- Targeting and monitoring mean arterial pressure in critical illness: A mixed-methods service evaluation.Journal of the Intensive Care Society · 2026Article
32 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Erratum issued
Authors and funding
5 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Vasopressors and fluids are the cornerstones for the treatment of shock. The current international guidelines on shock recommend norepinephrine as the first-line vasopressor and vasopressin as the second-line vasopressor. In clinical practice, due to drug availability, local practice variations, special settings, and ongoing research, several alternative vasoconstrictors and adjuncts are used in the absence of precise equivalent doses. Norepinephrine equivalence (NEE) is frequently used in clinical trials to overcome this heterogeneity and describe vasopressor support in a standardized manner. NEE quantifies the total amount of vasopressors, considering the potency of each such agent, which typically includes catecholamines, derivatives, and vasopressin. Intensive care studies use NEE as an eligibility criterion and also an outcome measure. On the other hand, NEE has several pitfalls which clinicians should know, important the lack of conversion of novel vasopressors such as angiotensin II and also adjuncts such as methylene blue, including a lack of high-quality data to support the equation and validate its predictive performance in all types of critical care practice. This review describes the history of NEE and suggests an updated formula incorporating novel vasopressors and adjuncts.
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.