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
Hauptverfasser: 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
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container_end_page 887
container_issue 9
container_start_page 877
container_title The New England journal of medicine
container_volume 358
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 . . .
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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><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. 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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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