Observational studyBMC infectious diseases2023
Timing of vasopressin initiation and mortality in patients with septic shock: analysis of the MIMIC-III and MIMIC-IV databases.
Observational study in BMC infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Early multimodal vasopressor strategy in septic shock: results of the TRICYCLE randomized controlled trial.Critical care (London, England) · 2026Trial
- Research Topics and Trends in MIMIC-IV: A Large ICU Database Relevant for Critical Care Nursing.Nursing in critical care · 2026Review
- When should we start vasopressin in septic shock? Revisiting an old question.Journal of intensive medicine · 2026Article
- Article
- Impact of Early versus Delayed Vasopressin Initiation on 28-Day Mortality in Older Adults with Septic Shock.Therapeutics and clinical risk management · 2026Article
- Exploring vasopressin use in septic shock: a retrospective cohort study from Türkiye (VASCO-TURK).BMC anesthesiology · 2025Observational
- Vasopressin Initiation Timing and In-Hospital Mortality in Septic Shock: An Observational Study of Large Public Databases.Critical care explorations · 2025Observational
- ChronoSynthNet: a dual-task deep learning model development and validation study for predicting real-time norepinephrine dosage and the early detection of hypotension in patients with septic shock.Cardiovascular diagnosis and therapy · 2025Article
- Vasopressin and its analogues in patients with septic shock: holy Grail or unfulfilled promise?Critical care (London, England) · 2025Review
- Vasopressin use across shock states: international insights from an international ESICM-endorsed survey: the PRESS Survey.Critical care (London, England) · 2025Article
- Analysis of the heterogeneous treatment effect of vasoactive drug dosage and time on hospital mortality across different sepsis phenotypes: a retrospective cohort study.European journal of medical research · 2025Article
- Novel therapies and interventions in sepsis and septic shock.BJA education · 2025Review
- Effect of Arginine Vasopressin on Human Neutrophil Function Under Physiological and Sepsis-Associated Conditions.International journal of molecular sciences · 2025Article
- Early multimodal vasopressor strategy in septic shock (TRICYCLE)-Study protocol for a randomized controlled clinical trial.PloS one · 2025Article
- Construction and validation of nomogram prediction model for clinical efficacy of high-dose continuous renal replacement therapy in sepsis patients based on inflammatory response and microcirculation.Frontiers in medicine · 2025Article
- Vasopressor Therapy.Journal of clinical medicine · 2024Review
- An optimal antibiotic selection framework for Sepsis patients using Artificial Intelligence.NPJ digital medicine · 2024Article
- Development and validation of a prediction model for in-hospital death in patients with heart failure and atrial fibrillation.BMC cardiovascular disorders · 2023Article
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Authors and funding
3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundvasopressin is commonly used as a second-line vasopressor for patients with septic shock, but the optimal timing of initiation is uncertain. This study was designed to investigate when vasopressin initiation may be beneficial for 28-day mortality in septic shock patients.
methodsThis was a retrospective observational cohort study from the MIMIC-III v1.4 and MIMIC-IV v2.0 databases. All adults diagnosed with septic shock according to Sepsis-3 criteria were included. Patients were stratified into two groups based on norepinephrine (NE) dose at the time of vasopressin initiation, defined as the low doses of NE group (NE<0.25 µg/kg/min) and the high doses of NE group (NE ≥ 0.25 µg/kg/min). The primary end-point was 28-day mortality after diagnosis of septic shock. The analysis involved propensity score matching (PSM), multivariable logistic regression, doubly robust estimation, the gradient boosted model, and an inverse probability-weighting model.
resultsA total of 1817 eligible patients were included in our original cohort (613 in the low doses of NE group and 1204 in the high doses of NE group). After 1:1 PSM, 535 patients from each group with no difference in disease severity were included in the analysis. The results showed that vasopressin initiation at low doses of NE was associated with reduced 28-day mortality (odds ratio [OR] 0.660, 95% confidence interval [CI] 0.518-0.840, p < 0.001). Compared with patients in the high doses of NE group, patients in the low doses of NE group received significantly shorter duration of NE, with less intravenous fluid volume on the first day after initiation of vasopressin, more urine on the second day, and longer mechanical ventilation-free days and CRRT-free days. Nevertheless, there were no significant differences in hemodynamic response to vasopressin, duration of vasopressin, and ICU or hospital length of stay.
conclusionsAmong adults with septic shock, vasopressin initiation when low-dose NE was used was associated with an improvement in 28-day mortality.
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