Fewer Episodes of Atrial Fibrillation When Vasopressin Is Combined with Norepinephrine

In a meta-analysis, managing distributive shock with norepinephrine plus vasopressin was associated with fewer episodes of AF.

Based on limited data, the Surviving Sepsis guidelines recommend vasopressin as a norepinephrine-sparing agent or as an adjunct for refractory hypotension. Using less catecholamine could help prevent arrhythmias or other complications of norepinephrine.

Investigators analyzed 23 studies in which norepinephrine alone was compared with norepinephrine plus vasopressin in >3000 patients with distributive shock. All but 1 study included patients with septic shock; most were single center and open label. Two large studies, VASST (NEJM JW Infect Dis Apr 2008 and N Engl J Med 2008; 358:877) and VANISH (NEJM JW Gen Med Oct 1 2016 and JAMA 2016; 316:509), contributed 40% of patients in the meta-analysis.

Based on data from 13 studies, patients were sig…

Reviewing Author

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

Fewer Episodes of Atrial Fibrillation When Vasopressin Is Combined with Norepinephrine

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Reviewing Author