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Microcirculation improvement after short-term infusion of vasopressin in septic shock is dependent on noradrenaline

Overview of attention for article published in Clinics, December 2017
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Title
Microcirculation improvement after short-term infusion of vasopressin in septic shock is dependent on noradrenaline
Published in
Clinics, December 2017
DOI 10.6061/clinics/2017(12)06
Pubmed ID
Authors

AP Nascente, FG Freitas, J Bakker, AT Bafi, RT Ladeira, LC Azevedo, A Lima, FR Machado

Abstract

To assess the impact of vasopressin on the microcirculation and to develop a predictive model to estimate the probability of microcirculatory recruitment in patients with septic shock. This prospective interventional study included patients with septic shock receiving noradrenaline for less than 48 hours. We infused vasopressin at 0.04 U/min for one hour. Hemodynamic measurements, including sidestream dark-field imaging, were obtained immediately before vasopressin infusion, 1 hour after vasopressin infusion and 1 hour after vasopressin withdrawal. We defined patients with more than a 10% increase in total vascular density and perfused vascular density as responders. ClinicalTrials.gov: NCT02053675. Eighteen patients were included, and nine (50%) showed improved microcirculation after infusion of vasopressin. The noradrenaline dose was significantly reduced after vasopressin (p=0.001) and was higher both at baseline and during vasopressin infusion in the responders than in the non-responders. The strongest predictor for a favorable microcirculatory response was the dose of noradrenaline at baseline (OR=4.5; 95% CI: 1.2-17.0; p=0.027). For patients using a noradrenaline dose higher than 0.38 mcg/kg/min, the probability that microcirculatory perfusion would be improved with vasopressin was 53% (sensitivity 78%, specificity 77%). In patients with septic shock for no longer than 48 h, administration of vasopressin is likely to result in an improvement in microcirculation when the baseline noradrenaline dose is higher than 0.38 mcg/kg/min.

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The data shown below were compiled from readership statistics for 26 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 26 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 6 23%
Student > Bachelor 4 15%
Professor > Associate Professor 2 8%
Student > Ph. D. Student 2 8%
Other 1 4%
Other 4 15%
Unknown 7 27%
Readers by discipline Count As %
Medicine and Dentistry 10 38%
Pharmacology, Toxicology and Pharmaceutical Science 2 8%
Agricultural and Biological Sciences 1 4%
Business, Management and Accounting 1 4%
Psychology 1 4%
Other 2 8%
Unknown 9 35%