Vasopressin versus Norepinephrine Infusion in Patients with Septic Shock
In a multicenter trial, 778 patients with septic shock who were being treated with catecholamine vasopressors were randomly assigned to either norepinephrine or vasopressin in addition to open-label vasopressors. There was no significant difference between the two groups in mortality at either 28 or...
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Veröffentlicht in: | The New England journal of medicine 2008-02, Vol.358 (9), p.877-887 |
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creator | Russell, James A Walley, Keith R Singer, Joel Gordon, Anthony C Hébert, Paul C Cooper, D. James Holmes, Cheryl L Mehta, Sangeeta Granton, John T Storms, Michelle M Cook, Deborah J Presneill, Jeffrey J Ayers, Dieter |
description | In a multicenter trial, 778 patients with septic shock who were being treated with catecholamine vasopressors were randomly assigned to either norepinephrine or vasopressin in addition to open-label vasopressors. There was no significant difference between the two groups in mortality at either 28 or 90 days, nor was there any significant difference in the rate of adverse events.
Patients with septic shock were randomly assigned to either norepinephrine or vasopressin in addition to open-label vasopressors. There was no significant difference between the two groups in mortality at either 28 or 90 days.
Septic shock is the most common cause of death in intensive care units (ICUs)
1
,
2
and has a mortality rate of 40 to 60%.
2
,
3
Resuscitation strategies include the administration of intravenous fluids and the use of catecholamines such as norepinephrine, epinephrine, dopamine, and dobutamine.
4
,
5
Although largely effective in reestablishing minimally acceptable mean arterial pressures to maintain organ perfusion, catecholamines have important adverse effects and may even increase mortality rates.
6
For example, norepinephrine, a potent and commonly used α-adrenergic agent in cases of septic shock, may decrease cardiac output, oxygen delivery, and blood flow to vulnerable organs despite adequate . . . |
doi_str_mv | 10.1056/NEJMoa067373 |
format | Article |
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Patients with septic shock were randomly assigned to either norepinephrine or vasopressin in addition to open-label vasopressors. There was no significant difference between the two groups in mortality at either 28 or 90 days.
Septic shock is the most common cause of death in intensive care units (ICUs)
1
,
2
and has a mortality rate of 40 to 60%.
2
,
3
Resuscitation strategies include the administration of intravenous fluids and the use of catecholamines such as norepinephrine, epinephrine, dopamine, and dobutamine.
4
,
5
Although largely effective in reestablishing minimally acceptable mean arterial pressures to maintain organ perfusion, catecholamines have important adverse effects and may even increase mortality rates.
6
For example, norepinephrine, a potent and commonly used α-adrenergic agent in cases of septic shock, may decrease cardiac output, oxygen delivery, and blood flow to vulnerable organs despite adequate . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJMoa067373</identifier><identifier>PMID: 18305265</identifier><identifier>CODEN: NEJMAG</identifier><language>eng</language><publisher>Boston, MA: Massachusetts Medical Society</publisher><subject>Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Blood pressure ; Blood Pressure - drug effects ; Catecholamines - administration & dosage ; Catecholamines - adverse effects ; Double-Blind Method ; Drug Therapy, Combination ; Emergency and intensive care: infection, septic shock ; Female ; General aspects ; Humans ; Hypotheses ; Infections ; Infusions, Intravenous ; Intensive care medicine ; Kaplan-Meier Estimate ; Male ; Medical diagnosis ; Medical research ; Medical sciences ; Middle Aged ; Mortality ; Norepinephrine - administration & dosage ; Norepinephrine - adverse effects ; Severity of Illness Index ; Shock, Septic - drug therapy ; Shock, Septic - mortality ; Shock, Septic - physiopathology ; Treatment Failure ; Vasoconstrictor Agents - administration & dosage ; Vasoconstrictor Agents - adverse effects ; Vasopressins - administration & dosage ; Vasopressins - adverse effects</subject><ispartof>The New England journal of medicine, 2008-02, Vol.358 (9), p.877-887</ispartof><rights>Copyright © 2008 Massachusetts Medical Society. All rights reserved.</rights><rights>2008 INIST-CNRS</rights><rights>Copyright 2008 Massachusetts Medical Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c500t-11fafcc9dffac16aaf960cf3e659d742609ae9cafa636c89b64a52a8c80d5d393</citedby><cites>FETCH-LOGICAL-c500t-11fafcc9dffac16aaf960cf3e659d742609ae9cafa636c89b64a52a8c80d5d393</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.nejm.org/doi/pdf/10.1056/NEJMoa067373$$EPDF$$P50$$Gmms$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/223925894?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,777,781,2746,2747,26084,27905,27906,52363,54045,64364,64368,72218</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20141056$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18305265$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Russell, James A</creatorcontrib><creatorcontrib>Walley, Keith R</creatorcontrib><creatorcontrib>Singer, Joel</creatorcontrib><creatorcontrib>Gordon, Anthony C</creatorcontrib><creatorcontrib>Hébert, Paul C</creatorcontrib><creatorcontrib>Cooper, D. James</creatorcontrib><creatorcontrib>Holmes, Cheryl L</creatorcontrib><creatorcontrib>Mehta, Sangeeta</creatorcontrib><creatorcontrib>Granton, John T</creatorcontrib><creatorcontrib>Storms, Michelle M</creatorcontrib><creatorcontrib>Cook, Deborah J</creatorcontrib><creatorcontrib>Presneill, Jeffrey J</creatorcontrib><creatorcontrib>Ayers, Dieter</creatorcontrib><creatorcontrib>VASST Investigators</creatorcontrib><title>Vasopressin versus Norepinephrine Infusion in Patients with Septic Shock</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>In a multicenter trial, 778 patients with septic shock who were being treated with catecholamine vasopressors were randomly assigned to either norepinephrine or vasopressin in addition to open-label vasopressors. There was no significant difference between the two groups in mortality at either 28 or 90 days, nor was there any significant difference in the rate of adverse events.
Patients with septic shock were randomly assigned to either norepinephrine or vasopressin in addition to open-label vasopressors. There was no significant difference between the two groups in mortality at either 28 or 90 days.
Septic shock is the most common cause of death in intensive care units (ICUs)
1
,
2
and has a mortality rate of 40 to 60%.
2
,
3
Resuscitation strategies include the administration of intravenous fluids and the use of catecholamines such as norepinephrine, epinephrine, dopamine, and dobutamine.
4
,
5
Although largely effective in reestablishing minimally acceptable mean arterial pressures to maintain organ perfusion, catecholamines have important adverse effects and may even increase mortality rates.
6
For example, norepinephrine, a potent and commonly used α-adrenergic agent in cases of septic shock, may decrease cardiac output, oxygen delivery, and blood flow to vulnerable organs despite adequate . . .</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Blood pressure</subject><subject>Blood Pressure - drug effects</subject><subject>Catecholamines - administration & dosage</subject><subject>Catecholamines - adverse effects</subject><subject>Double-Blind Method</subject><subject>Drug Therapy, Combination</subject><subject>Emergency and intensive care: infection, septic shock</subject><subject>Female</subject><subject>General aspects</subject><subject>Humans</subject><subject>Hypotheses</subject><subject>Infections</subject><subject>Infusions, Intravenous</subject><subject>Intensive care medicine</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Norepinephrine - administration & dosage</subject><subject>Norepinephrine - adverse effects</subject><subject>Severity of Illness Index</subject><subject>Shock, Septic - drug therapy</subject><subject>Shock, Septic - mortality</subject><subject>Shock, Septic - physiopathology</subject><subject>Treatment Failure</subject><subject>Vasoconstrictor Agents - administration & dosage</subject><subject>Vasoconstrictor Agents - adverse effects</subject><subject>Vasopressins - administration & dosage</subject><subject>Vasopressins - adverse effects</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpt0MFLwzAUBvAgipvTm2cpojerSdNkzVHGdBOdwtRreUsTlrk2NWkV_3szVtSD7_De5cf34EPomOBLghm_mo3vHixgPqRDuoP6hFEapynmu6iPcZLF6VDQHjrwfoXDkFTsox7JKGYJZ300eQVva6e8N1X0oZxvfTSzTtWmUvXShR1NK916Y6soiCdojKoaH32aZhnNVd0YGc2XVr4doj0Na6-OujtALzfj59Ekvn-8nY6u72PJMG5iQjRoKUWhNUjCAbTgWGqqOBPFME04FqCEBA2ccpmJBU-BJZDJDBesoIIO0Ok2t3b2vVW-yVe2dVV4mScJFQnLRBrQxRZJZ713Sue1MyW4r5zgfNNa_re1wE-6zHZRquIXdzUFcN4B8BLW2kEljf9xSah1kxrc2daVpc8rtSr___cNguyAtw</recordid><startdate>20080228</startdate><enddate>20080228</enddate><creator>Russell, James A</creator><creator>Walley, Keith R</creator><creator>Singer, Joel</creator><creator>Gordon, Anthony C</creator><creator>Hébert, Paul C</creator><creator>Cooper, D. James</creator><creator>Holmes, Cheryl L</creator><creator>Mehta, Sangeeta</creator><creator>Granton, John T</creator><creator>Storms, Michelle M</creator><creator>Cook, Deborah J</creator><creator>Presneill, Jeffrey J</creator><creator>Ayers, Dieter</creator><general>Massachusetts Medical Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TZ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K0Y</scope><scope>LK8</scope><scope>M0R</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope></search><sort><creationdate>20080228</creationdate><title>Vasopressin versus Norepinephrine Infusion in Patients with Septic Shock</title><author>Russell, James A ; Walley, Keith R ; Singer, Joel ; Gordon, Anthony C ; Hébert, Paul C ; Cooper, D. James ; Holmes, Cheryl L ; Mehta, Sangeeta ; Granton, John T ; Storms, Michelle M ; Cook, Deborah J ; Presneill, Jeffrey J ; Ayers, Dieter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c500t-11fafcc9dffac16aaf960cf3e659d742609ae9cafa636c89b64a52a8c80d5d393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Blood pressure</topic><topic>Blood Pressure - drug effects</topic><topic>Catecholamines - administration & dosage</topic><topic>Catecholamines - adverse effects</topic><topic>Double-Blind Method</topic><topic>Drug Therapy, Combination</topic><topic>Emergency and intensive care: infection, septic shock</topic><topic>Female</topic><topic>General aspects</topic><topic>Humans</topic><topic>Hypotheses</topic><topic>Infections</topic><topic>Infusions, Intravenous</topic><topic>Intensive care medicine</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Norepinephrine - administration & dosage</topic><topic>Norepinephrine - adverse effects</topic><topic>Severity of Illness Index</topic><topic>Shock, Septic - drug therapy</topic><topic>Shock, Septic - mortality</topic><topic>Shock, Septic - physiopathology</topic><topic>Treatment Failure</topic><topic>Vasoconstrictor Agents - administration & dosage</topic><topic>Vasoconstrictor Agents - adverse effects</topic><topic>Vasopressins - administration & dosage</topic><topic>Vasopressins - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Russell, James A</creatorcontrib><creatorcontrib>Walley, Keith R</creatorcontrib><creatorcontrib>Singer, Joel</creatorcontrib><creatorcontrib>Gordon, Anthony C</creatorcontrib><creatorcontrib>Hébert, Paul C</creatorcontrib><creatorcontrib>Cooper, D. James</creatorcontrib><creatorcontrib>Holmes, Cheryl L</creatorcontrib><creatorcontrib>Mehta, Sangeeta</creatorcontrib><creatorcontrib>Granton, John T</creatorcontrib><creatorcontrib>Storms, Michelle M</creatorcontrib><creatorcontrib>Cook, Deborah J</creatorcontrib><creatorcontrib>Presneill, Jeffrey J</creatorcontrib><creatorcontrib>Ayers, Dieter</creatorcontrib><creatorcontrib>VASST Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Pharma and Biotech Premium PRO</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>New England Journal of Medicine</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><jtitle>The New England journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Russell, James A</au><au>Walley, Keith R</au><au>Singer, Joel</au><au>Gordon, Anthony C</au><au>Hébert, Paul C</au><au>Cooper, D. James</au><au>Holmes, Cheryl L</au><au>Mehta, Sangeeta</au><au>Granton, John T</au><au>Storms, Michelle M</au><au>Cook, Deborah J</au><au>Presneill, Jeffrey J</au><au>Ayers, Dieter</au><aucorp>VASST Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vasopressin versus Norepinephrine Infusion in Patients with Septic Shock</atitle><jtitle>The New England journal of medicine</jtitle><addtitle>N Engl J Med</addtitle><date>2008-02-28</date><risdate>2008</risdate><volume>358</volume><issue>9</issue><spage>877</spage><epage>887</epage><pages>877-887</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><coden>NEJMAG</coden><abstract>In a multicenter trial, 778 patients with septic shock who were being treated with catecholamine vasopressors were randomly assigned to either norepinephrine or vasopressin in addition to open-label vasopressors. There was no significant difference between the two groups in mortality at either 28 or 90 days, nor was there any significant difference in the rate of adverse events.
Patients with septic shock were randomly assigned to either norepinephrine or vasopressin in addition to open-label vasopressors. There was no significant difference between the two groups in mortality at either 28 or 90 days.
Septic shock is the most common cause of death in intensive care units (ICUs)
1
,
2
and has a mortality rate of 40 to 60%.
2
,
3
Resuscitation strategies include the administration of intravenous fluids and the use of catecholamines such as norepinephrine, epinephrine, dopamine, and dobutamine.
4
,
5
Although largely effective in reestablishing minimally acceptable mean arterial pressures to maintain organ perfusion, catecholamines have important adverse effects and may even increase mortality rates.
6
For example, norepinephrine, a potent and commonly used α-adrenergic agent in cases of septic shock, may decrease cardiac output, oxygen delivery, and blood flow to vulnerable organs despite adequate . . .</abstract><cop>Boston, MA</cop><pub>Massachusetts Medical Society</pub><pmid>18305265</pmid><doi>10.1056/NEJMoa067373</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Blood pressure Blood Pressure - drug effects Catecholamines - administration & dosage Catecholamines - adverse effects Double-Blind Method Drug Therapy, Combination Emergency and intensive care: infection, septic shock Female General aspects Humans Hypotheses Infections Infusions, Intravenous Intensive care medicine Kaplan-Meier Estimate Male Medical diagnosis Medical research Medical sciences Middle Aged Mortality Norepinephrine - administration & dosage Norepinephrine - adverse effects Severity of Illness Index Shock, Septic - drug therapy Shock, Septic - mortality Shock, Septic - physiopathology Treatment Failure Vasoconstrictor Agents - administration & dosage Vasoconstrictor Agents - adverse effects Vasopressins - administration & dosage Vasopressins - adverse effects |
title | Vasopressin versus Norepinephrine Infusion in Patients with Septic Shock |
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