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The following is a summary of “Extremely early initiation of vasopressors might not decrease short-term mortality for adults with septic shock: a systematic review and meta-analysis,” published in the January 2025 issue of Critical Care by Ma et al.
Researchers conducted a retrospective study to assess the impact of early vs late vasopressor initiation on clinical outcomes in patients with septic shock.
They searched PubMed, Embase, and Cochrane databases. Studies comparing early and late vasopressor initiation in patients with septic shock were included. Short-term mortality was the primary outcome, and subgroup analyses based on different initiation timings were performed.
The results showed 11 studies with 6,661 patients were included. The definition of ‘early administration’ varied, ranging from 1 to 7 hours. In the combined analysis of 3,757 patients from 2 RCTs and 3 quasi-experimental studies, no significant difference in short-term mortality was found between early and late vasopressor initiation (OR: 0.66, 95% CI: [0.36, 1.19], I2 : 82%). However, early initiation (1 to 3 hours) showed lower mortality (OR: 0.70, 95% CI: [0.60, 0.82], I2: 0%), as did using septic shock diagnosis as time 0 (OR: 0.64, 95% CI: [0.48, 0.85], I2: 39%).
Investigators concluded the earlier vasopressor initiation, particularly within 1 to 3 hours of septic shock diagnosis, might reduce short-term mortality in certain subgroups, though further standardized research is needed to determine the optimal timing.
Source: pubmed.ncbi.nlm.nih.gov/39865207/
