The following is a summary of “Optimizing Vasopressin Use and Initiation Timing in Septic Shock: A Narrative Review,” published in the November 2023 issue of Pulmonology by Sacha et al.
For a study, researchers sought to determine why vasopressin was used, recap the outcomes of clinical studies that tested vasopressin, and focus on when to start vasopressin so that doctors can know how to start it most effectively in patients with septic shock. Vasoactive drugs are needed to get enough blood to the tissues of people who have septic shock.
After norepinephrine, vasopressin is recommended as a second-line drug to help people whose mean artery pressure stays too low. Vasopressin use varies in real life, most likely because of mixed results from clinical trials, a lack of clear guidelines for when it should be used, and the high cost of getting the drug. Although it has these problems, vasopressin has shown price inelastic demand, and its use in the US has continued to rise.
However, there were still questions about the best way to use vasopressin in people with septic shock, especially about which patients to treat and when to start giving them vasopressin. Few experimental studies have looked at when to start vasopressin in people with septic shock. However, new observational studies have found a link between starting vasopressin at lower norepinephrine-equivalent amounts or lower lactate concentrations and lower mortality.
Source: sciencedirect.com/science/article/abs/pii/S0012369223010322