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Previous studies have identified a relative deficiency of endogenous vasopressin in patients with septic shock, suggesting that vasopressin use might reduce the need for vasopressor support in these patients. To determine whether vasopressin has a norepinephrine-sparing effect, researchers conducted a multicenter, double-blind, randomized trial of 778 patients with septic shock who did not respond to fluids and low-dose norepinephrine. Patients were randomized to receive either low-dose vasopressin (0.01–0.03 U per minute) or higher doses of norepinephrine (5–15 μg per minute). Other open-label vasopressors were used at the clinicians’ discretion.
Before randomization, patients were stratified into two groups based on severity of septic shoc…