The impact of endocrine supplementation on adverse events in septic shock

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

Research output: Contribution to journalArticle

5 Scopus citations

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 2015

Keywords

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

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Bissell, B. D., Erdman, M. J., Smotherman, C., Kraemer, D. F., & 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