Early vasopressin administration in septic shock: A systematic review, meta-analysis, and multicenter retrospective observational study.
Eur J Intern MedMay 8, 2026 (epub)
Chiwon Ahn, Gun Tak Lee, Jae Hwan Kim et al.
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In 30 seconds
This study evaluated the timing of vasopressin initiation in septic shock through a multicenter registry analysis and a systematic review with meta-analysis. The analysis included 2001 patients and found that starting vasopressin at an NE dose ≥0.5 μg/kg/min was linked to higher 28-day mortality (aOR 2.15). Early initiation was associated with lower mortality in observational studies (OR 0.71).
Key findings
- Initiating vasopressin at an NE dose ≥0.5 μg/kg/min was associated with higher 28-day mortality (aOR 2.15).
- Delays of 6-24 hours in vasopressin initiation were linked to increased mortality (aOR 1.59).
- In RCTs, early vasopressin initiation did not reduce mortality (OR 0.84) but decreased renal replacement therapy needs (OR 0.46).
- Observational studies showed early initiation was associated with lower mortality (OR 0.71) and shorter ICU length of stay (mean difference -1.06 days).
Why it matters
Understanding the optimal timing for vasopressin administration in septic shock is crucial for improving patient outcomes. This study highlights the potential benefits of early initiation, particularly in observational settings, which may inform clinical decision-making.