Table 3 Hemodynamic drug support and RCTs in septic shock
Acronym | Studied drugs | Type of study | No. of patients (n) | Primary outcome | Main results | Authors [ref.] |
|---|---|---|---|---|---|---|
VASST | AVP versus NE | RCT, double blind, multicenter | 778 (396 vs. 382) | Mortality at day 28 | No difference; significantly lower mortality in patients with NE < 15 µg/min | Russell et al. [12] |
VASST (post hoc according to sepsis 3.0) | AVP versus NE | RCT, double blind, multicenter | 375 (193 vs. 182) | Mortality at day 28 | Significantly lower mortality in patients with lactate ≤ 2 mmol/L | Russell et al. [77] |
VANISH | AVP versus NE (subsequently HCT versus placebo) | 2 × 2 RCT, double blind, multicenter | 409 (104 vs. 103 vs. 101 vs. 101) | Kidney failure-free days until day 28 | No difference | Gordon et al. [41] |
VANC | AVP versus NE | RCT, double blind, single center | 300 (149 vs. 151) | Mortality and/or severe complications | Significantly less acute renal failure and atrial fibrillation | Hajjar et al. [78] |
SEPSIS-ACT | Selepressin versus NE | RCT, double blind, multicenter | 53 (32 vs. 21) | MAP > 65 mmHg without NE; NE dose | Significantly lower NE load, less net fluid intake, more ventilator-free days | Russell et al. [81] |
LeoPARDS | Levosimendan versus standard treatment alone | RCT, double blind, multicenter | 516 (259 vs. 257) | SOFA score up to day 28 | No difference; higher incidence in supraventricular tachyarrhythmia | Gordon et al. [83] |
ATHOS-3 | Angiotensin II versus NE | RCT, double blind, multicenter | 321 (163 vs. 158) | Target MAP > 75 mmHg at 3 h | Significantly more patients with target achieved; higher reduction in SOFA score at 48 h | Khanna et al. [86] |
nn | Esmolol versus conventional treatment | Open label, RCT, single center | 154 (77 vs. 77) | 80 < heart rate < 95 over 96 h | Significantly lower mortality at day 28 | Morelli et al. [88] |