OBJECTIVE: To examine the benefits and risks of vasopressin or its analog terlipressin for patients with vasodilatory shock. DATA SOURCE: We searched the CENTRAL, MEDLINE, EMBASE, and LILACS databases (up to March 2011) as well as reference lists of articles and proceedings of major meetings; we also contacted trial authors. We considered randomized and quasirandomized trials of vasopressin or terlipressin versus placebo or supportive treatment in adult and pediatric patients with vasodilatory shock. The primary outcome for this review was short-term all-cause mortality. STUDY SELECTION: We identified 10 randomized trials (1,134 patients). Six studies were considered for the main analysis on mortality in adults. DATA EXTRACTION AND SYNTHESIS: The crude short-term mortality was 206 of 512 (40.2%) in vasopressin/terlipressin-treated patients and 198 of 461 (42.9%) in controls [six trials, risk ratio (RR) = 0.91; 95% confidence interval (CI) 0.79-1.05; P = 0.21; I(2) = 0%]. There were 49 of 463 (10.6%) patients with serious adverse events in the vasopressin/terlipressin arm and 51 of 431 (11.8%) in the control arm (four trials, RR = 0.90; 95% CI 0.49-1.67; P = 0.75; I(2) = 26%). Metaregression analysis showed negative correlation between vasopressin dose and norepinephrine dose (P = 0.03). CONCLUSIONS: Overall, use of vasopressin or terlipressin did not produce any survival benefit in the short term in patients with vasodilatory shock. Physicians may value the sparing effects of vasopressin/terlipressin on norepinephrine requirement given its apparent safe profile.
OBJECTIVE: To examine the benefits and risks of vasopressin or its analog terlipressin for patients with vasodilatory shock. DATA SOURCE: We searched the CENTRAL, MEDLINE, EMBASE, and LILACS databases (up to March 2011) as well as reference lists of articles and proceedings of major meetings; we also contacted trial authors. We considered randomized and quasirandomized trials of vasopressin or terlipressin versus placebo or supportive treatment in adult and pediatric patients with vasodilatory shock. The primary outcome for this review was short-term all-cause mortality. STUDY SELECTION: We identified 10 randomized trials (1,134 patients). Six studies were considered for the main analysis on mortality in adults. DATA EXTRACTION AND SYNTHESIS: The crude short-term mortality was 206 of 512 (40.2%) in vasopressin/terlipressin-treated patients and 198 of 461 (42.9%) in controls [six trials, risk ratio (RR) = 0.91; 95% confidence interval (CI) 0.79-1.05; P = 0.21; I(2) = 0%]. There were 49 of 463 (10.6%) patients with serious adverse events in the vasopressin/terlipressin arm and 51 of 431 (11.8%) in the control arm (four trials, RR = 0.90; 95% CI 0.49-1.67; P = 0.75; I(2) = 26%). Metaregression analysis showed negative correlation between vasopressin dose and norepinephrine dose (P = 0.03). CONCLUSIONS: Overall, use of vasopressin or terlipressin did not produce any survival benefit in the short term in patients with vasodilatory shock. Physicians may value the sparing effects of vasopressin/terlipressin on norepinephrine requirement given its apparent safe profile.
Authors: P J Devereaux; B J Manns; W A Ghali; H Quan; C Lacchetti; V M Montori; M Bhandari; G H Guyatt Journal: JAMA Date: 2001-04-18 Impact factor: 56.272
Authors: Karen Choong; Desmond Bohn; Douglas D Fraser; Isabelle Gaboury; James S Hutchison; Ari R Joffe; Catherine Litalien; Kusum Menon; Patrick McNamara; Roxanne E Ward Journal: Am J Respir Crit Care Med Date: 2009-07-16 Impact factor: 21.405
Authors: R Phillip Dellinger; Mitchell M Levy; Jean M Carlet; Julian Bion; Margaret M Parker; Roman Jaeschke; Konrad Reinhart; Derek C Angus; Christian Brun-Buisson; Richard Beale; Thierry Calandra; Jean-Francois Dhainaut; Herwig Gerlach; Maurene Harvey; John J Marini; John Marshall; Marco Ranieri; Graham Ramsay; Jonathan Sevransky; B Taylor Thompson; Sean Townsend; Jeffrey S Vender; Janice L Zimmerman; Jean-Louis Vincent Journal: Crit Care Med Date: 2008-01 Impact factor: 7.598
Authors: James A Russell; Keith R Walley; Joel Singer; Anthony C Gordon; Paul C Hébert; D James Cooper; Cheryl L Holmes; Sangeeta Mehta; John T Granton; Michelle M Storms; Deborah J Cook; Jeffrey J Presneill; Dieter Ayers Journal: N Engl J Med Date: 2008-02-28 Impact factor: 91.245
Authors: A Morelli; C Ertmer; M Lange; M Dünser; S Rehberg; H Van Aken; P Pietropaoli; M Westphal Journal: Br J Anaesth Date: 2008-02-27 Impact factor: 9.166
Authors: M Habicher; T Zajonz; M Heringlake; A Böning; S Treskatsch; U Schirmer; A Markewitz; M Sander Journal: Anaesthesist Date: 2018-05 Impact factor: 1.041
Authors: Sebastian Rehberg; Yusuke Yamamoto; Linda Sousse; Eva Bartha; Collette Jonkam; Anthony K Hasselbach; Lillian D Traber; Robert A Cox; Martin Westphal; Perenlei Enkhbaatar; Daniel L Traber Journal: Am J Physiol Heart Circ Physiol Date: 2012-09-07 Impact factor: 4.733