Early high-dose vasopressors in refractory septic shock: A cohort study
Main finding · Death within 28 daysResult — go to the resultHazard ratio 0.76 95 % CI 0.58–0.99Authors' conclusion
In vasopressor-refractory septic shock, achieving the peak vasopressor dose within the first six hours of shock onset was associated with reduced mortality and more days alive and free from organ-support therapies.
Study context
- Population
- Adults requiring vasopressor dose ≥0.5 μg/kg/min norepinephrine-equivalents in the first 24 h of septic shock
- Participants
- 351 vs 351
- Exposure
- Early vs late time to peak vasopressor dose
- Earlyn = 351
- Laten = 351reference
- Outcome
- Mortality
- Follow-up
- 28 days
Methodological detailsmultivariable Cox proportional hazards regression, severity-adjusted
- Multivariable Cox proportional hazards regression
- Severity-adjusted
Main finding
Death within 28 days
Hazard ratio
0.76
95 % CI 0.58–0.99
Early vs Late
HR 0.76 (95 % CI 0.58–0.99)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95 % CI) | |
|---|---|---|
| Independence from vasopressorsQuicker in the Early group | 1.40 (1.17–1.69) | |
| 0.512Hazard ratio (log scale) |
Days alive and free from RRT, vasopressors, mechanical ventilation
- Significantly more in the Early group
Safety
Mesenteric ischaemia and arrhythmias
- More frequent in the Late group
Original publication
Early high-dose vasopressors in refractory septic shock: A cohort study. J Crit Care. Published 14 December 2024. doi:10.
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