Which vasopressor to wean first

Join now. Follow us on:. Search PracticeUpdate Cancel. There are no guidelines available that recommend the order in which vasopressors are to be withdrawn. In this study, the authors performed a meta-analysis of nine studies involving patients in whom norepinephrine or vasopressin was withdrawn first to compare the risk of hypotension. An increased risk of hypotension was observed when vasopressin was withdrawn first OR, 3. The order in which vasopressors are withdrawn has not been studied prospectively; however, the data from this meta-analysis suggest that further research should be performed to guide clinicians.

Respiratory Medicine Written by. Richard M Schwartzstein MD. This abstract is available on the publisher's site. Additional Info. Discuss an article about which vasopressor should be stopped first.

Share a resource that reviews noteworthy Emergency Medicine articles from When a patient is being weaned off of multiple vasopressor therapy, pharmacists are often asked which vasopressor should be weaned off first. The ideal order of vasopressor weaning is unknown. The authors of this study evaluated the incidence of hypotension within 24 hours based on the discontinuation order of norepinephrine NE and vasopressin AVP in patients in the recovery phase of septic shock.

The study was a retrospective cohort in 3 ICUs within a single academic medical center. Patients had to have received fixed-dose vasopressin therapy for at least 6 hours as an adjunct to norepinephrine.

Hypotension was recorded during the hour period after discontinuation of the first vasoactive agent if the mean arterial pressure dropped below 60 mm Hg AND the nurse had to do one or more of the following interventions:. No significant difference between groups was found with regards to the incidence of hypotension or ICU mortality.

After adjustment for baseline factors with multivariable Cox proportional hazards regression, having vasopressin discontinued first was independently associated with an increased risk of hypotension. Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. References 1. Article Google Scholar 2. Article Google Scholar 4. Acknowledgements Not applicable. Funding Not applicable. Availability of data and materials Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.

View author publications. Ethics declarations Ethics approval and consent to participate Not applicable. Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. Additional information See related research by Jeon et al. About this article.

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