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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
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Early versus delayed vasopressor administration in patients with septic shock
Toshikazu Abe1,2,3, Yutaka Umemura4,5, Hiroshi Ogura5
1Department of Emergency and Critical Care Medicine Tsukuba Memorial Hospital Tsukuba Japan.
Acute Medicine & Surgery
|May 30, 2023
Summary
Early vasopressor administration in septic shock patients did not show a significant difference in mortality. However, it may help prevent fluid overload during sepsis treatment.
Area of Science:
- Critical Care Medicine
- Sepsis Research
- Pharmacological Interventions
Background:
- Septic shock management is time-sensitive.
- Vasopressor therapy is crucial for hemodynamic stability.
- The optimal timing for vasopressor initiation remains debated.
Purpose of the Study:
- To investigate the association between early vasopressor initiation and outcomes in septic shock.
- To evaluate the impact of early vs. delayed vasopressor administration on in-hospital mortality.
- To explore the effect on fluid balance in septic shock patients.
Main Methods:
- Multicenter observational study in 17 Japanese ICUs.
- Included adult sepsis patients treated with vasopressors (July 2019-August 2020).
- Compared early (≤1h) vs. delayed (>1h) vasopressor initiation using propensity score-weighted logistic regression.
Main Results:
- 97 patients included: 67 early, 30 delayed vasopressor initiation.
- In-hospital mortality: 32.8% (early) vs. 26.7% (delayed) (p=0.543).
- Adjusted odds ratio for mortality: 0.76 (95% CI 0.17-3.29). Early initiation showed a trend towards lower infusion volume over time.
Conclusions:
- Study did not reach a definitive conclusion on early vasopressor administration's impact on mortality.
- Early vasopressor administration may potentially help avoid volume overload in sepsis care.
- Further research is needed to confirm the benefits of early vasopressor use in septic shock.
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