Timing of vasopressin initiation influences renal outcomes in mixed cardiogenic-vasodilatory shock supported by VA-ECMO
Authors' conclusion
Early vasopressin administration in VA-ECMO-supported mixed shock may reduce the incidence of acute kidney injury compared with no vasopressin use, without increasing adverse events.
Study context
- Population
- Patients with mixed cardiogenic-vasodilatory shock supported by VA-ECMObicentric
- Participants
- 480 patients
- Exposure
- Early or late vasopressin after VA-ECMO initiation vs no vasopressin
- No vasopressinn = 289reference
- Earlyn = 98
- Laten = 93
- Outcome
- New-onset or worsening AKI
- Follow-up
- 30 days
Methodological detailsbicentric, multivariate logistic regression, propensity score-based inverse probability of treatment weighting (IPTW)
- Bicentric
- Multivariate logistic regression
- Propensity score-based IPTW
Main finding
As reported in the abstract
Early vs No vasopressinOdds ratio (CI)P value
Unadjusted; CI₉₅%
0.35(0.21–0.59)
P = 0.001Adjusted multivariate logistic regression; CI₉₅%
0.42(0.231–0.771)
P = 0.005Observational data: associations, not effects.
Further findings
Baseline norepinephrine-equivalent requirement · spread kind not named in abstract (bracketed values)
- Baseline norepinephrine-equivalent requirement: p < 0.001
Mortality
- Did not differ between the three groups
Safety
Digestive ischemia
- Did not differ between the three groups
Original publication
Timing of vasopressin initiation influences renal outcomes in mixed cardiogenic-vasodilatory shock supported by VA-ECMO. Anaesth Crit Care Pain Med. Published 7 November 2025. doi:10.
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