Comparison of Early and Late Norepinephrine Administration in Patients With Septic Shock: A Systematic Review and Meta-Analysis
Authors' conclusion
Overall mortality did not differ significantly between early and late norepinephrine administration for septic shock.
Study context
- Population
- Adults with sepsis / septic shock12 studies (4 RCTs, 8 observational)
- Participants
- 7,281 adults
- Comparison
- Early vs late norepinephrine
- Outcome
- Overall mortality
Pooled result
As reported in the abstract
Early norepinephrine vs Late norepinephrineOdds ratio (95% CI)
RCTs; no significant difference
0.70(0.41–1.19)
Observational studies; no significant difference
0.83(0.54–1.29)
Further pooled results
| Outcome | OR (95% CI) | |
|---|---|---|
| Overall mortality, 2 RCTs without restrictive fluid strategy (subgroup)Significantly lower mortality | 0.49 (0.25–0.96) | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | Mean difference (95% CI) | |
|---|---|---|
| Mechanical ventilator-free days (observational studies) | 4.06 (2.82–5.30) | |
| −50510Difference (linear scale) |
Other secondary outcomes (ICU LOS, RRT-free days, vasopressor-free days, adverse events, total fluid volume)
- No differences found
Safety
| Outcome | OR (95% CI) | |
|---|---|---|
| Pulmonary edema (3 RCTs) | 0.43 (0.25–0.74) | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Comparison of Early and Late Norepinephrine Administration in Patients With Septic Shock: A Systematic Review and Meta-Analysis. Chest. Published 5 July 2024. doi:10.
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