TY - JOUR
T1 - Effect of Early Administration of Vasopressin on New-Onset Arrhythmia Development in Patients With Septic Shock
T2 - A Retrospective, Observational Cohort Study
AU - McCloskey, Michele M.
AU - Gibson, Gabrielle A.
AU - Pope, Hannah E.
AU - Giacomino, Bria D.
AU - Hampton, Nicholas
AU - Micek, Scott T.
AU - Kollef, Marin H.
AU - Betthauser, Kevin D.
N1 - Funding Information:
The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: K.D.B. discloses being a member of La Jolla Pharmaceutical Company’s speaker’s bureau. M.H.K.’s research efforts are supported by the Barnes-Jewish Hospital Foundation.
Publisher Copyright:
© The Author(s) 2023.
PY - 2023
Y1 - 2023
N2 - Background: Adjunctive vasopressin use in septic shock reduces catecholamine requirements and is associated with a lower incidence of new-onset arrhythmias (NOAs). The association of vasopressin timing on NOA development is ill-described. Objective: To determine whether early administration of vasopressin was associated with a lower incidence of NOA in septic shock patients. Methods: A retrospective analysis of intensive care unit (ICU) patients at a large, academic medical center. Septic shock patients who required vasopressin and norepinephrine were eligible for inclusion. Patients were excluded for receipt of other vasoactive agents, history of cardiac arrhythmias, or outside hospital admission. Early vasopressin was defined as receipt within 6 hours of septic shock onset. The primary outcome was incidence of NOA. Results: In total, 436 patients, 220 (50.4%) in the early and 216 (49.6%) in the late vasopressin group, were included. Early vasopressin was not associated with a lower incidence of NOA compared with late vasopressin (9% vs 7%, median absolute difference [95% confidence interval, CI]: −2.1 [−7.2, 3.0], P = 0.41). Early vasopressin patients were observed to have shorter shock duration (2 vs 4 days, median absolute difference [95% CI]: 2 [1, 2], P < 0.001), and ICU length of stay (6 vs 7 days, median absolute difference [95% CI]: 1 [0, 2], P = 0.02). Conclusions and Relevance: Early vasopressin use was not associated with a lower incidence of NOA. Additional studies are needed to elucidate the effect of vasopressin timing on NOA and other clinical outcomes.
AB - Background: Adjunctive vasopressin use in septic shock reduces catecholamine requirements and is associated with a lower incidence of new-onset arrhythmias (NOAs). The association of vasopressin timing on NOA development is ill-described. Objective: To determine whether early administration of vasopressin was associated with a lower incidence of NOA in septic shock patients. Methods: A retrospective analysis of intensive care unit (ICU) patients at a large, academic medical center. Septic shock patients who required vasopressin and norepinephrine were eligible for inclusion. Patients were excluded for receipt of other vasoactive agents, history of cardiac arrhythmias, or outside hospital admission. Early vasopressin was defined as receipt within 6 hours of septic shock onset. The primary outcome was incidence of NOA. Results: In total, 436 patients, 220 (50.4%) in the early and 216 (49.6%) in the late vasopressin group, were included. Early vasopressin was not associated with a lower incidence of NOA compared with late vasopressin (9% vs 7%, median absolute difference [95% confidence interval, CI]: −2.1 [−7.2, 3.0], P = 0.41). Early vasopressin patients were observed to have shorter shock duration (2 vs 4 days, median absolute difference [95% CI]: 2 [1, 2], P < 0.001), and ICU length of stay (6 vs 7 days, median absolute difference [95% CI]: 1 [0, 2], P = 0.02). Conclusions and Relevance: Early vasopressin use was not associated with a lower incidence of NOA. Additional studies are needed to elucidate the effect of vasopressin timing on NOA and other clinical outcomes.
KW - administration
KW - arrhythmia
KW - septic shock
KW - timing
KW - vasopressin
UR - http://www.scopus.com/inward/record.url?scp=85153306358&partnerID=8YFLogxK
U2 - 10.1177/10600280221095543
DO - 10.1177/10600280221095543
M3 - Article
C2 - 37056040
AN - SCOPUS:85153306358
SN - 1060-0280
JO - Annals of Pharmacotherapy
JF - Annals of Pharmacotherapy
ER -