The aim of this observational study is to examine real-world clinical practice regarding the use of vasopressin as a second-line vasopressor in adult patients admitted to Intensive Care Units (ICUs) with septic shock. The study focuses on critically ill adults (≥18 years) diagnosed with septic shock and treated with norepinephrine and vasopressin. The main research questions are: * Does early initiation of vasopressin-defined by the norepinephrine dose at the time of introduction-reduce mortality in patients with septic shock? * What is the impact of vasopressin as a second vasopressor on renal function and the progression of organ dysfunction in septic shock patients? Participants will: * Be admitted to an ICU with a diagnosis of septic shock. * Receive vasopressin as an adjunct to norepinephrine for hemodynamic support. * Be monitored daily throughout their ICU stay, with data collected through a dedicated REDCap system. * Have relevant clinical data pseudonymized and incorporated into the study database for statistical analysis.
Study Type
OBSERVATIONAL
Enrollment
1,200
A state-of-the-art line of research in septic shock management focuses on the potential use of a second vasopressor agent. Current efforts aim to determine which drug should be used and the optimal timing for its initiation. In line with this, the Surviving Sepsis Campaign 2021 clinical guide recommends considering vasopressin-arginine (VAP) as a second-line vasopressor when norepinephrine (NAD) doses exceed 0.25 µg/kg/min, although this suggestion is based on limited evidence and remains weak.
Consorci Sanitari de Terrassa
Terrassa, BARCELONA, Spain
RECRUITINGHospital Universitario de Getafe
Getafe, Madrid, Spain
RECRUITINGHospital Universitario La Princesa
Madrid, Madrid, Spain
RECRUITINGHospital General Universitario Gregorio Marañón
Madrid, Madrid, Spain
RECRUITINGHospital Universitario Ramón y Cajal
Madrid, Madrid, Spain
RECRUITINGHospital Universitario Clínico San Carlos
Madrid, Madrid, Spain
RECRUITINGHospital Universitario Doce de Octubre
Madrid, Madrid, Spain
RECRUITINGHospital Universitario La Paz
Madrid, Madrid, Spain
RECRUITINGHospital Universitario Puerta de Hierro
Majadahonda, Madrid, Spain
RECRUITINGHospital Universitario Rey Juan Carlos
Móstoles, Madrid, Spain
RECRUITING...and 2 more locations
Prognostic impact, in terms of all-cause mortality, of early VAP initiation in patients with septic shock.
Time frame: From patient ICU-admission to 30 days after or patient ICU-discharge.
Impact of vasopressin usage as a second vasopressor on renal function.
Renal function will be assessed using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria for acute kidney injury (AKI). KDIGO stages range from 0 (no AKI) to 3 (severe AKI), with higher stages indicating worse renal function. KDIGO classification will be recorded at 24, 48, and 72 hours after vasopressin initiation, as well as the highest stage reached during the entire ICU stay. In addition to KDIGO staging, the need for renal replacement therapy (RRT) during admission will also be recorded as an indicator of progression to kidney failure.
Time frame: From patient ICU-admission to 30 days after or patient ICU-discharge.
Impact of VAP use as a second vasopressor on the progression of organ dysfunction.
Organ dysfunction will be measured using the Sequential Organ Failure Assessment (SOFA) score, which ranges from 0 (no organ dysfunction) to 24 (severe multi-organ failure). Higher scores indicate worse outcomes. SOFA score will be recorded at 24, 48, and 72 hours after vasopressin initiation, as well as the maximum SOFA score obtained during the ICU stay.
Time frame: From patient ICU-admission to 30 days after or patient ICU-discharge.
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