The Vasopressin Loading for Refractory septic shock (VALOR) study: a prospective observational study
Authors' conclusion
Vasopressin loading may be safely introduced for septic shock. Vasopressin loading may be used to predict responses to its continuous infusion and select appropriate strategies to increase blood pressure.
Study context
- Population
- Patients with septic shock treated with ≥ 0.2 μg/kg/min noradrenaline, given vasopressin loading (1 U bolus then 1U/h infusion)
- Participants
- 92 patients
- Exposure
- Vasopressin loading responders vs non-responders
- Respondersn = 62
- Outcome
- Change in catecholamine index (CAI)
- Follow-up
- 6 h
Main finding
As reported in the abstract
Change in CAI
Responders
- 10
median
Non-responders
0
median
P < 0.0001
Observational data: associations, not effects.
Further findings
Prediction of catecholamine index (CAI) change < 0 after continuous infusion by mean arterial pressure (MAP) change with vasopressin loading
- AUROC
- 0.843
- Sensitivity
- 0.92
- Specificity
- 0.77
Blood adrenocorticotropic hormone levels
- Significantly higher in non-responders
Haemodynamics (arterial pressure wave analysis)
- Stroke volume variations higher in responders before loading; stroke volume and dP/dtmax higher in responders after loading
Safety
Ischemia events (digital, mesenteric, myocardial) during admission
- Ischemia events, all patients
- 5 cases (5.4%)
Original publication
The Vasopressin Loading for Refractory septic shock (VALOR) study: a prospective observational study. Crit Care. Published 21 July 2023. doi:10.
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