Acute cardiac care & resuscitation
Association of Vasopressin Plus Catecholamine Vasopressors vs Catecholamines Alone With Atrial Fibrillation in Patients With Distributive Shock: A Systematic Review and Meta-analysis
Authors' conclusion
In this systematic review and meta-analysis, the addition of vasopressin to catecholamine vasopressors compared with catecholamines alone was associated with a lower risk of atrial fibrillation.
Study context
- Population
- Patients with distributive shock
- Participants
- 3,088 patients23 RCTs
- Comparison
- Vasopressin + catecholamine vasopressors vs catecholamines alone
- Outcome
- Atrial fibrillation
Methodological detailsrandom-effects model
- Random-effects model
Pooled result
As reported in the abstract
Vasopressin vs Catecholamines aloneRelative risk (95% CI)
Vasopressin + catecholaminesvs catecholamines alone; high-quality evidence
0.77(0.67–0.88)
Vasopressin vs Catecholamines aloneRisk difference (95% CI)
Vasopressin + catecholaminesvs catecholamines alone
−0.06(−0.13 to 0.01)
Further pooled results
Mortality
- Overall RR
- 0.89 (95% CI, 0.82 to 0.97)
- Overall RD
- −0.04 (95% CI, −0.07 to 0.00)
- RR, trials at low risk of bias only
- 0.96 (95% CI, 0.84 to 1.11)
Renal replacement therapy
- Overall RR
- 0.74 (95% CI, 0.51 to 1.08)
- Overall RD
- −0.07 (95% CI, −0.12 to −0.01)
- RR, trials at low risk of bias only
- 0.70 (95% CI, 0.53 to 0.92)
- P for interaction = .77
MI (myocardial injury), ventricular arrhythmia, stroke, ICU and hospital length of stay (LOS)
- No significant differences in pooled risks for other outcomes
Original publication
Association of Vasopressin Plus Catecholamine Vasopressors vs Catecholamines Alone With Atrial Fibrillation in Patients With Distributive Shock: A Systematic Review and Meta-analysis. JAMA. Published 8 May 2018. doi:10.
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