1350: Norepinephrine and Vasopressin vs Norepinephrine Alone for Septic Shock: Randomized Controlled Trial

Association of Vasopressin Plus Catecholamine Vasopressors vs Catecholamines Alone With Atrial Fibrillation in Patients With Distributive Shock

“…Two studies evaluated patients with post-cardiac surgery vasoplegia. 18,28 Vasopressin was the intervention in 13 trials, 18,23,24,[27][28][29][30][33][34][35][36][37]39 whereas 9 studied terlipressin, [20][21][22]25,26,32,35,38,41 1 studied selepressin, 40 and 1 studied pituitrin (a mixture of vasopressin and oxytocin). 31 One 3-group study compared vasopressin vs terlipressin vs norepinephrine alone.…”

Clinical Efficiency of Vasopressin or Its Analogs in Comparison With Catecholamines Alone on Patients With Septic Shock: A Systematic Review and Meta-Analysis

“…The development of arrhythmia was documented in nine RCTs with 358 events (Russell et al, 2008;Morelli et al, 2009;Barzegar et al, 2016;Clem et al, 2016;Gordon et al, 2016;Choudhury et al, 2017;Russell et al, 2017;Liu et al, 2018;Laterre et al, 2019). We observed no significant difference in the occurrence of arrhythmia between two groups [RR=1.05 (95% CI, 0.87-1.27), P=0.61, I 2 = 25%] (Supplemental Figure S2).…”

“…Twenty-three RCTs with 4,225 septic shock patients were enrolled in the systematic review and meta-analysis (Albanese et al, 2005;Lauzier et al, 2006;Morelli et al, 2008;Russell et al, 2008;Acevedo et al, 2009;Morelli et al, 2009;Han et al, 2012;Svoboda et al, 2012;Fonseca-Ruiz et al, 2013;Hua et al, 2013;Oliveira et al, 2014;Zambolim et al, 2014;Barzegar et al, 2016;Clem et al, 2016;Gordon et al, 2016;Xiao et al, 2016;Capoletto et al, 2017;Chen et al, 2017;Choudhury et al, 2017;Prakash et al, 2017;Russell et al, 2017;Liu et al, 2018;Laterre et al, 2019). The majority of enrolled trials were designed as singlecenter studies, while seven of them were multicenter studies.…”

“…The administration of vasopressin was applied by 10 trials, and another 11 RCTs using terlipressin as the intervention, whereas selepressin was studied in two trials. Among them, six studies were published in conference abstract (Acevedo et al, 2009;Oliveira et al, 2014;Zambolim et al, 2014;Clem et al, 2016;Capoletto et al, 2017;Prakash et al, 2017). The detailed characteristics of all included RCTs were presented in Table 1.…”

“…Given that 14 trials with a total of 3,206 patients reported total adverse events (980 events) (Lauzier et al, 2006;Russell et al, 2008;Morelli et al, 2009;Fonseca-Ruiz et al, 2013;Zambolim et al, 2014;Barzegar et al, 2016;Clem et al, 2016;Gordon et al, 2016;Xiao et al, 2016;Choudhury et al, 2017;Prakash et al, 2017; Russell et al, 2017;Liu et al, 2018;Laterre et al, 2019), administration of vasopressin or its analogs showed no significant association with the incidence of adverse effects [RR=1.21 (95% CI, 0.88-1.68), P=0.24, I 2 = 73%] (Supplemental Figure S1). Although this outcome displayed a relatively high heterogeneity, the conclusion was proven to be stable after performing sensitivity analysis via excluding each study one at a time from the pooled estimate.…”