"Vasopressin vs Norepinephrine in Septic Shock". The New England Journal of Medicine. Date unknown. Volume and issue unknown: Page numbers unknown. PubMed
Links to original sources: Wiki Journal Post Full Journal Article
Does low-dose vasopressin reduce mortality among patients with septic shock who are being treated with catecholamine vasopressors compared to norepinephrine?
Low-dose vasopressin did not reduce mortality rates as compared with norepinephrine among patients with septic shock who were treated with catecholamine vasopressors.
The Vasopressin and Septic Shock Trial (VASST) evaluated the effect of low-dose vasopressin versus norepinephrine in patients with septic shock already treated with conventional vasopressors. The study aimed to determine if vasopressin, utilized for its potential to restore vascular tone and blood pressure in septic shock, could decrease mortality when compared to norepinephrine. The trial concluded that there was no significant difference in mortality at 28 days and 90 days between the vasopressin and norepinephrine groups.
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- Multicenter, randomized, double-blind trial. - N=778 patients with septic shock on a minimum of 5 μg of norepinephrine per minute. - Intervention: Low-dose vasopressin (0.01 to 0.03 U per minute) (n=396) vs norepinephrine (5 to 15 μg per minute) (n=382). - All vasopressor infusions were titrated and tapered to maintain a target blood pressure.
- Patients age 16 and older with septic shock and low-dose norepinephrine. - Excluded if septic shock was unresponsive to fluids or if specific exclusion criteria were met.
- Patients received either low-dose vasopressin or norepinephrine infusion in addition to open-label vasopressors, titrated to maintain target blood pressure.
- Primary: 28-day mortality rate. - Secondary: 90-day mortality, days free of organ dysfunction, vasopressor use, ventilation, SIRS, corticosteroid use, and length of ICU and hospital stay. - Serious adverse events.
- Infusion range of vasopressin was fixed, and no adjustments were made based on vasopressin levels.
- Canadian Institutes of Health Research.
Original study: The New England Journal of Medicine (Link provided in the full article).