The impact of endocrine supplementation on adverse events in septic shock

Brittany D. Bissell, Michael J. Erdman, Carmen Smotherman, Dale Kraemer, Jason A. Ferreira

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: The objective of this study was to compare the incidence of severe adverse events of vasopressin vs hydrocortisone for endocrine support therapy in patients with septic shock. Materials and methods: This was a retrospective, propensity-matched cohort of patients admitted to the medical intensive care unit with septic shock between February 2012 and February 2015. Patients were included if vasopressin or hydrocortisone was administered for hemodynamic support secondary to norepinephrine. Results: In the unmatched cohort of 124 patients, vasopressin was associated with a significant decrease in the number of severe adverse events (P = .03). In the matched cohort, severe adverse events occurred 3 times as often in patients receiving hydrocortisone; however, this difference was not statistically significant. (odds ratio, 3.33; 95% confidence interval, 0.92-12.11; P = .06). In the matched cohort, vasopressin was associated with a faster time to hemodynamic stability (P < .05) and discontinuation of hemodynamic support (P < .01) with an increased requirement for third-line therapy (P < .01). No statistical differences were seen in length of stay (intensive care unit and hospital), length of mechanical ventilation, and in-hospital mortality. Conclusion: Given the lower incidence of adverse events and faster time to hemodynamic stability, vasopressin appears to be the most advantageous endocrine agent for hemodynamic support in septic shock.

Original languageEnglish (US)
Article number51909
Pages (from-to)1169-1173
Number of pages5
JournalJournal of Critical Care
Volume30
Issue number6
DOIs
StatePublished - Dec 1 2015
Externally publishedYes

Fingerprint

Septic Shock
Vasopressins
Hemodynamics
Hydrocortisone
Intensive Care Units
Incidence
Hospital Mortality
Artificial Respiration
Length of Stay
Norepinephrine
Odds Ratio
Confidence Intervals
Therapeutics

Keywords

  • Adverse drug event
  • Corticosteroids
  • Hemodynamics
  • Norepinephrine
  • Septic shock
  • Vasopressin

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Bissell, B. D., Erdman, M. J., Smotherman, C., Kraemer, D., & Ferreira, J. A. (2015). The impact of endocrine supplementation on adverse events in septic shock. Journal of Critical Care, 30(6), 1169-1173. [51909]. https://doi.org/10.1016/j.jcrc.2015.08.025

The impact of endocrine supplementation on adverse events in septic shock. / Bissell, Brittany D.; Erdman, Michael J.; Smotherman, Carmen; Kraemer, Dale; Ferreira, Jason A.

In: Journal of Critical Care, Vol. 30, No. 6, 51909, 01.12.2015, p. 1169-1173.

Research output: Contribution to journalArticle

Bissell, BD, Erdman, MJ, Smotherman, C, Kraemer, D & Ferreira, JA 2015, 'The impact of endocrine supplementation on adverse events in septic shock', Journal of Critical Care, vol. 30, no. 6, 51909, pp. 1169-1173. https://doi.org/10.1016/j.jcrc.2015.08.025
Bissell, Brittany D. ; Erdman, Michael J. ; Smotherman, Carmen ; Kraemer, Dale ; Ferreira, Jason A. / The impact of endocrine supplementation on adverse events in septic shock. In: Journal of Critical Care. 2015 ; Vol. 30, No. 6. pp. 1169-1173.
@article{dc4a657962d4436bbc418a1a28b8444a,
title = "The impact of endocrine supplementation on adverse events in septic shock",
abstract = "Purpose: The objective of this study was to compare the incidence of severe adverse events of vasopressin vs hydrocortisone for endocrine support therapy in patients with septic shock. Materials and methods: This was a retrospective, propensity-matched cohort of patients admitted to the medical intensive care unit with septic shock between February 2012 and February 2015. Patients were included if vasopressin or hydrocortisone was administered for hemodynamic support secondary to norepinephrine. Results: In the unmatched cohort of 124 patients, vasopressin was associated with a significant decrease in the number of severe adverse events (P = .03). In the matched cohort, severe adverse events occurred 3 times as often in patients receiving hydrocortisone; however, this difference was not statistically significant. (odds ratio, 3.33; 95{\%} confidence interval, 0.92-12.11; P = .06). In the matched cohort, vasopressin was associated with a faster time to hemodynamic stability (P < .05) and discontinuation of hemodynamic support (P < .01) with an increased requirement for third-line therapy (P < .01). No statistical differences were seen in length of stay (intensive care unit and hospital), length of mechanical ventilation, and in-hospital mortality. Conclusion: Given the lower incidence of adverse events and faster time to hemodynamic stability, vasopressin appears to be the most advantageous endocrine agent for hemodynamic support in septic shock.",
keywords = "Adverse drug event, Corticosteroids, Hemodynamics, Norepinephrine, Septic shock, Vasopressin",
author = "Bissell, {Brittany D.} and Erdman, {Michael J.} and Carmen Smotherman and Dale Kraemer and Ferreira, {Jason A.}",
year = "2015",
month = "12",
day = "1",
doi = "10.1016/j.jcrc.2015.08.025",
language = "English (US)",
volume = "30",
pages = "1169--1173",
journal = "Journal of Critical Care",
issn = "0883-9441",
publisher = "Elsevier BV",
number = "6",

}

TY - JOUR

T1 - The impact of endocrine supplementation on adverse events in septic shock

AU - Bissell, Brittany D.

AU - Erdman, Michael J.

AU - Smotherman, Carmen

AU - Kraemer, Dale

AU - Ferreira, Jason A.

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Purpose: The objective of this study was to compare the incidence of severe adverse events of vasopressin vs hydrocortisone for endocrine support therapy in patients with septic shock. Materials and methods: This was a retrospective, propensity-matched cohort of patients admitted to the medical intensive care unit with septic shock between February 2012 and February 2015. Patients were included if vasopressin or hydrocortisone was administered for hemodynamic support secondary to norepinephrine. Results: In the unmatched cohort of 124 patients, vasopressin was associated with a significant decrease in the number of severe adverse events (P = .03). In the matched cohort, severe adverse events occurred 3 times as often in patients receiving hydrocortisone; however, this difference was not statistically significant. (odds ratio, 3.33; 95% confidence interval, 0.92-12.11; P = .06). In the matched cohort, vasopressin was associated with a faster time to hemodynamic stability (P < .05) and discontinuation of hemodynamic support (P < .01) with an increased requirement for third-line therapy (P < .01). No statistical differences were seen in length of stay (intensive care unit and hospital), length of mechanical ventilation, and in-hospital mortality. Conclusion: Given the lower incidence of adverse events and faster time to hemodynamic stability, vasopressin appears to be the most advantageous endocrine agent for hemodynamic support in septic shock.

AB - Purpose: The objective of this study was to compare the incidence of severe adverse events of vasopressin vs hydrocortisone for endocrine support therapy in patients with septic shock. Materials and methods: This was a retrospective, propensity-matched cohort of patients admitted to the medical intensive care unit with septic shock between February 2012 and February 2015. Patients were included if vasopressin or hydrocortisone was administered for hemodynamic support secondary to norepinephrine. Results: In the unmatched cohort of 124 patients, vasopressin was associated with a significant decrease in the number of severe adverse events (P = .03). In the matched cohort, severe adverse events occurred 3 times as often in patients receiving hydrocortisone; however, this difference was not statistically significant. (odds ratio, 3.33; 95% confidence interval, 0.92-12.11; P = .06). In the matched cohort, vasopressin was associated with a faster time to hemodynamic stability (P < .05) and discontinuation of hemodynamic support (P < .01) with an increased requirement for third-line therapy (P < .01). No statistical differences were seen in length of stay (intensive care unit and hospital), length of mechanical ventilation, and in-hospital mortality. Conclusion: Given the lower incidence of adverse events and faster time to hemodynamic stability, vasopressin appears to be the most advantageous endocrine agent for hemodynamic support in septic shock.

KW - Adverse drug event

KW - Corticosteroids

KW - Hemodynamics

KW - Norepinephrine

KW - Septic shock

KW - Vasopressin

UR - http://www.scopus.com/inward/record.url?scp=84947017955&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84947017955&partnerID=8YFLogxK

U2 - 10.1016/j.jcrc.2015.08.025

DO - 10.1016/j.jcrc.2015.08.025

M3 - Article

VL - 30

SP - 1169

EP - 1173

JO - Journal of Critical Care

JF - Journal of Critical Care

SN - 0883-9441

IS - 6

M1 - 51909

ER -