Sepsis & septic shock · Choice of vasopressor
Vasopressin versus norepinephrine infusion in patients with septic shock
| Design | Multicentre, double-blind randomised controlled trial |
|---|---|
| Treatment | Low-dose vasopressin added to open-label vasopressors |
| Control | Noradrenaline added to open-label vasopressors |
| Population | 778 patients with septic shock already receiving catecholamine vasopressors |
| Follow-up | 90 days |
| Primary endpoint | 28-day all-cause mortality |
| Result | 396 patients received vasopressin and 382 noradrenaline. There was no significant difference in mortality between the groups. |
| Secondary endpoints | 90-day mortality, organ dysfunction, serious adverse events |
Low-dose vasopressin did not reduce mortality rates as compared with norepinephrine among patients with septic shock who were treated with catecholamine vasopressors.
The trial authors, in the published abstract
Vasopressin remains widely used as a catecholamine-sparing agent, which is a defensible aim this trial neither supports nor refutes — it tested mortality, and found none. The same distinction applies to ATHOS-3 and angiotensin II.
Russell JA, Walley KR, Singer J, et al. Vasopressin versus norepinephrine infusion in patients with septic shock. N Engl J Med 2008 Feb 28;358(9):877-87.