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Sepsis & Septic Shock

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Timing of Vasopressin Addition to Norepinephrine and Efficacy Outcomes in Patients With Septic Shock


  1. 🏥 The trial examined the effect of the timing of vasopressin (AVP) addition to norepinephrine (NE) on septic shock patients' clinical outcomes, conducted retrospectively in a single health system over several sites from January 2018 to December 2019. 🕰️

  2. 👥 The trial included 243 patients out of the initial 497, with patients being above 18, diagnosed with septic shock, and having received NE followed by AVP. Those with certain medical conditions or who were pregnant were excluded. 🚫

  3. 🕑 Two groups were formed based on when AVP was added to NE treatment: an early group (within 3 hours) and a late group (after 3 hours). ⌛

  4. 📊 Both groups had balanced characteristics at NE initiation. Still, differences were noticed in the SOFA score, weight, administration of hydrocortisone and vitamin C, and fluid dose prior to NE initiation. 📈

  5. ⏳ The early AVP group had a significantly shorter median time for shock resolution (37.6 hours) compared to the late group (60.7 hours). ⌛

  6. 🏨 Although there were no significant differences in ICU or hospital mortality rates, the early AVP group had a shorter ICU stay. 🛌

  7. 📝 The results suggest that adding AVP within 3 hours of NE initiation could reduce the time for shock resolution in septic shock patients. Yet, the impact of other interventions, like vitamin C administration and fluid dose before NE initiation, is still uncertain. 💡

🔍 Summary: The trial revealed that early addition of AVP (within 3 hours) to NE in septic shock treatment significantly shortens the time for shock resolution, although the influence of other interventions on the outcome remains unknown.


Brask AL, Shemanski SM, Barnes TE, Holmes AK. Timing of Vasopressin Addition to Norepinephrine and Efficacy Outcomes in Patients With Septic Shock. Ann Pharmacother. 2023 May;57(5):521-526. doi: 10.1177/10600280221118903. Epub 2022 Aug 29. Erratum in: Ann Pharmacother. 2023 Jan 5;:10600280231151309. PMID: 36039490.


#SepticShock #Vasopressin #Norepinephrine #ShockResolution #ICUStay

Mazen Kherallah
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