Combination of norepinephrine with phenylephrine versus norepinephrine with vasopressin in critically ill patients with septic shock: A retrospective study

被引:5
作者
Arishi, Hatim [1 ]
AlQahtani, Samah [1 ]
Tamim, Hani [2 ,4 ]
Sadat, Musharaf [1 ]
Alenezi, Farhan Zayed [1 ]
Bin Humaid, Felwa [3 ]
AlWehaibi, Wedyan [3 ]
Arabi, Yaseen M. [1 ]
机构
[1] King Saud bin Abdulaziz Univ Hlth Sci, Coll Med, King Abdullah Int Med Res Ctr, Intens Care Dept,King Abdulaziz Med City,Minist Na, Riyadh, Saudi Arabia
[2] Amer Univ Beirut, Clin Res Inst, Med Ctr, Beirut, Lebanon
[3] Minist Natl Guard Hlth Affairs, Intens Care Dept, King Abdullah Int Med Res Ctr, King Abdulaziz Med City, Riyadh, Saudi Arabia
[4] AlFaisal Univ, Coll Med, Riyadh, Saudi Arabia
关键词
Septic shock; Critical care; Vasoactive agents; Norepinephrine; Phenylephrine; Vasopressin; Mortality; SEVERE SEPSIS; MANAGEMENT; MORTALITY; AGENTS;
D O I
10.1016/j.jcrc.2022.154121
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Purpose: To evaluate the outcomes of patients with septic shock treated with a combination of norepinephrine with phenylephrine compared to norepinephrine with vasopressin.Materials and methods: This was a retrospective cohort study including adults admitted between 2002 and 2017 with septic shock according to the Sepsis 3 criteria. We compared outcomes of patients treated with norepineph-rine with phenylephrine to those treated with norepinephrine with vasopressin. Multivariate analysis was car-ried out to evaluate the association of norepinephrine with phenylephrine compared to norepinephrine with vasopressin with in-hospital mortality.Results: During the study period, 158 patients with septic shock were treated with norepinephrine with phenyl-ephrine and 129 with norepinephrine with vasopressin. Crude in-hospital mortality was not different between the two groups [91/158 (57.6%) versus 80/129 (62.5%), p = 0.40]. There was also no difference in ICU length of stay or hospital length of stay. Multivariate analysis demonstrated no significant association of norepinephrine with phenylephrine with in-hospital mortality compared to norepinephrine with vasopressin (OR 0.62 (95% con-fidence interval 0.31, 1.23, p = 0.17).Conclusion: Phenylephrine used as a second-line vasoactive agent combined with norepinephrine may be a rea-sonable option compared to vasopressin. However, this finding needs to be validated in a randomized controlled trial.(c) 2022 Published by Elsevier Inc.
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页数:5
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