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Myc LA, Stine JG, Chakrapani R, et al. Vasopressin use in critically ill cirrhosis patients with catecholamine-resistant septic shock: The CVICU cohort. World J Hepatol. 2017;9(2):106-113doi: 10.4254/wjh.v9.i2.106.
Myc, L. A., Stine, J. G., Chakrapani, R., Kadl, A., & Argo, C. K. (2017). Vasopressin use in critically ill cirrhosis patients with catecholamine-resistant septic shock: The CVICU cohort. World journal of hepatology, 9(2), 106-113. https://doi.org/10.4254/wjh.v9.i2.106
Myc, Lukasz A, et al. "Vasopressin use in critically ill cirrhosis patients with catecholamine-resistant septic shock: The CVICU cohort." World journal of hepatology vol. 9,2 (2017): 106-113. doi: https://doi.org/10.4254/wjh.v9.i2.106
Myc LA, Stine JG, Chakrapani R, Kadl A, Argo CK. Vasopressin use in critically ill cirrhosis patients with catecholamine-resistant septic shock: The CVICU cohort. World J Hepatol. 2017 Jan 18;9(2):106-113. doi: 10.4254/wjh.v9.i2.106. PMID: 28144392; PMCID: PMC5241528.
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World J Hepatol. 2017 Jan 18;9(2):106-113. doi: 10.4254/wjh.v9.i2.106.

Vasopressin use in critically ill cirrhosis patients with catecholamine-resistant septic shock: The CVICU cohort.

World journal of hepatology

Lukasz A Myc, Jonathan G Stine, Rinita Chakrapani, Alexandra Kadl, Curtis K Argo

Affiliations

  1. Lukasz A Myc, Department of Medicine, University of Virginia, Charlottesville, VA 22908, United States.

PMID: 28144392 PMCID: PMC5241528 DOI: 10.4254/wjh.v9.i2.106

Abstract

AIM: To examine patient-centered outcomes with vasopressin (AVP) use in patients with cirrhosis with catecholamine-refractory septic shock.

METHODS: We conducted a single center, retrospective cohort study enrolling adult patients with cirrhosis treated for catecholamine-resistant septic shock in the intensive care unit (ICU) from March 2011 through December 2013. Other etiologies of shock were excluded. Multivariable regression models were constructed for seven and 28-d mortality comparing AVP as a second-line therapy to a group of all other vasoactive agents.

RESULTS: Forty-five consecutive patients with cirrhosis were treated for catecholamine-resistant septic shock; 21 received AVP while the remaining 24 received another agent [phenylephrine (10), dopamine (6), norepinephrine (4), dobutamine (2), milrinone (2)]. In general, no significant differences in baseline demographics, etiology of cirrhosis, laboratory values, vital signs or ICU mortality/severity of illness scores were observed with the exception of higher MELD scores in the AVP group (32.4, 95%CI: 28.6-36.2

CONCLUSION: AVP is similar in terms of patient centered outcomes of seven and 28-d mortality, in comparison to all other vasopressors when used as a second line vasoactive agent in catecholamine resistant septic shock. Large-scale prospective study would help to refine current consensus standards and provide further support to our findings.

Keywords: Hepatology; Intensive care unit; Liver; Portal hypertension; Vasopressor

Conflict of interest statement

Conflict-of-interest statement: We have no conflicts of interest to report.

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