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Predictors of Vasopressin Responsiveness in Critically Ill Adults.

Publication ,  Journal Article
Allen, B; Kram, B; Kram, S; Schultheis, J; Wolf, S; Gilstrap, D; Shapiro, M
Published in: Ann Pharmacother
February 2018

BACKGROUND: Vasopressin is commonly used as an adjunct vasopressor in shock. However, response to vasopressin varies among critically ill patients. OBJECTIVE: To identify patient-specific factors that are associated with vasopressin responsiveness in critically ill adults. METHODS: This retrospective, multicenter study included adult patients who were admitted to an intensive care unit (ICU) and received vasopressin for shock. Patients were excluded if they received vasopressin for less than 30 minutes, if vasopressin was initiated prior to ICU arrival, or if an additional vasopressor was initiated within 30 minutes of starting vasopressin. Responsiveness was defined as an increase in mean arterial pressure of ≥10 mm Hg or the ability to taper a concurrent catecholamine vasopressor. Patient-specific factors evaluated in a multivariate analysis included age, gender, ethnicity, body mass index, type of shock, serum pH, Sequential Organ Failure Assessment (SOFA) score, and use of stress-dose steroids. These variables were also evaluated in a subgroup analysis of patients with septic shock. RESULTS: Of 1619 patients screened, 400 patients were included, with 231 identified as vasopressin responsive and 169 as nonresponsive. Vasopressin used as an adjunct vasopressor, as opposed to first line, during shock was the only variable associated with vasopressin responsiveness (odds ratio [OR] = 1.71; 95% CI = 1.10 to 2.65). Among the subgroup of patients with septic shock, female patients had a higher odds of responding than male patients (OR = 2.10; 95% CI = 1.12 to 3.95). CONCLUSIONS: Vasopressin initiated as an adjunct vasopressor, as opposed to first-line therapy, was associated with response.

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Published In

Ann Pharmacother

DOI

EISSN

1542-6270

Publication Date

February 2018

Volume

52

Issue

2

Start / End Page

126 / 132

Location

United States

Related Subject Headings

  • Vasopressins
  • Vasoconstrictor Agents
  • Shock, Septic
  • Retrospective Studies
  • Pharmacology & Pharmacy
  • Middle Aged
  • Male
  • Intensive Care Units
  • Humans
  • Female
 

Citation

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Allen, B., Kram, B., Kram, S., Schultheis, J., Wolf, S., Gilstrap, D., & Shapiro, M. (2018). Predictors of Vasopressin Responsiveness in Critically Ill Adults. Ann Pharmacother, 52(2), 126–132. https://doi.org/10.1177/1060028017729480
Allen, Brittainy, Bridgette Kram, Shawn Kram, Jennifer Schultheis, Steven Wolf, Daniel Gilstrap, and Mark Shapiro. “Predictors of Vasopressin Responsiveness in Critically Ill Adults.Ann Pharmacother 52, no. 2 (February 2018): 126–32. https://doi.org/10.1177/1060028017729480.
Allen B, Kram B, Kram S, Schultheis J, Wolf S, Gilstrap D, et al. Predictors of Vasopressin Responsiveness in Critically Ill Adults. Ann Pharmacother. 2018 Feb;52(2):126–32.
Allen, Brittainy, et al. “Predictors of Vasopressin Responsiveness in Critically Ill Adults.Ann Pharmacother, vol. 52, no. 2, Feb. 2018, pp. 126–32. Pubmed, doi:10.1177/1060028017729480.
Allen B, Kram B, Kram S, Schultheis J, Wolf S, Gilstrap D, Shapiro M. Predictors of Vasopressin Responsiveness in Critically Ill Adults. Ann Pharmacother. 2018 Feb;52(2):126–132.
Journal cover image

Published In

Ann Pharmacother

DOI

EISSN

1542-6270

Publication Date

February 2018

Volume

52

Issue

2

Start / End Page

126 / 132

Location

United States

Related Subject Headings

  • Vasopressins
  • Vasoconstrictor Agents
  • Shock, Septic
  • Retrospective Studies
  • Pharmacology & Pharmacy
  • Middle Aged
  • Male
  • Intensive Care Units
  • Humans
  • Female