{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T13:43:31Z","timestamp":1777729411920,"version":"3.51.4"},"reference-count":39,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2015,12,17]],"date-time":"2015-12-17T00:00:00Z","timestamp":1450310400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of the Intensive Care Society"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Septic shock is a life-threatening condition requiring vasopressor agents to support the circulatory system. Several agents exist with choice typically guided by the specific clinical scenario. We used a network meta-analysis approach to rate the comparative efficacy and safety of vasopressors for mortality and arrhythmia incidence in septic shock patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a comprehensive electronic database search including Medline, Embase, Science Citation Index Expanded and the Cochrane database. Randomised trials investigating vasopressor agents in septic shock patients and specifically assessing 28-day mortality or arrhythmia incidence were included. A Bayesian network meta-analysis was performed using Markov chain Monte Carlo methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen trials of low to moderate risk of bias in which 3146 patients were randomised were included. There was no pairwise evidence to suggest one agent was superior over another for mortality. In the network meta-analysis, vasopressin was significantly superior to dopamine (OR 0.68 (95% CI 0.5 to 0.94)) for mortality. For arrhythmia incidence, standard pairwise meta-analyses confirmed that dopamine led to a higher incidence of arrhythmias than norepinephrine (OR 2.69 (95% CI 2.08 to 3.47)). In the network meta-analysis, there was no evidence of superiority of one agent over another.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this network meta-analysis, vasopressin was superior to dopamine for 28-day mortality in septic shock. Existing pairwise information supports the use of norepinephrine over dopamine. Our findings suggest that dopamine should be avoided in patients with septic shock and that other vasopressor agents should continue to be based on existing guidelines and clinical judgement of the specific presentation of the patient.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1751143715620203","type":"journal-article","created":{"date-parts":[[2015,12,17]],"date-time":"2015-12-17T23:53:14Z","timestamp":1450396394000},"page":"136-145","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Comparative safety and efficacy of vasopressors for mortality in septic shock: A network meta-analysis"],"prefix":"10.1177","volume":"17","author":[{"given":"Myura","family":"Nagendran","sequence":"first","affiliation":[{"name":"Section of Anaesthetics, Pain Medicine and Intensive Care, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahiben","family":"Maruthappu","sequence":"additional","affiliation":[{"name":"North West Thames Foundation School, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony C","family":"Gordon","sequence":"additional","affiliation":[{"name":"Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Imperial College London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kurinchi S","family":"Gurusamy","sequence":"additional","affiliation":[{"name":"Department of Surgery, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,12,17]]},"reference":[{"key":"bibr1-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1208623"},{"key":"bibr2-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1208943"},{"key":"bibr3-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0907118"},{"key":"bibr4-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067373"},{"key":"bibr5-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31827e83af"},{"key":"bibr6-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31823778ee"},{"key":"bibr7-1751143715620203","first-page":"CD003709","volume":"5","author":"Havel C","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr8-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1177\/0885066610396312"},{"key":"bibr9-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1186\/cc11469"},{"key":"bibr10-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(97)00049-8"},{"key":"bibr11-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1875"},{"key":"bibr12-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1201"},{"key":"bibr13-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f2914"},{"key":"bibr14-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1177\/0962280207080643"},{"key":"bibr15-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2014.04.011"},{"key":"bibr16-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"bibr17-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1001\/2012.jama.11228"},{"key":"bibr18-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010683.pub2"},{"key":"bibr19-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwp014"},{"key":"bibr20-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X12458724"},{"key":"bibr21-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X13485157"},{"key":"bibr22-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X13487604"},{"key":"bibr23-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X12455847"},{"key":"bibr24-1751143715620203","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1080\/10618600.1998.10474787","volume":"7","author":"Brooks SP","year":"1998","journal-title":"J Comput Graph Statist"},{"key":"bibr25-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200107000-00002"},{"key":"bibr26-1751143715620203","doi-asserted-by":"crossref","unstructured":"Annane D, Vignon P, Renault A, et al. Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock: a randomised trial.\n                      Lancet\n                      2007; 370: 676\u2013684.","DOI":"10.1016\/S0140-6736(07)61344-0"},{"key":"bibr27-1751143715620203","doi-asserted-by":"crossref","unstructured":"Lauzier F, L\u00e9vy B, Lamarre P, et al. Vasopressin or norepinephrine in early hyperdynamic septic shock: a randomized clinical trial.\n                      Intensive Care Med\n                      2006; 32: 1782\u20131789.","DOI":"10.1007\/s00134-006-0378-0"},{"key":"bibr28-1751143715620203","doi-asserted-by":"crossref","unstructured":"Mahmoud KM and Ammar AS. Norepinephrine supplemented with dobutamine or epinephrine for the cardiovascular support of patients with septic shock.\n                      Indian J Crit Care Med\n                      2012; 16: 75\u201380.","DOI":"10.4103\/0972-5229.99110"},{"key":"bibr29-1751143715620203","doi-asserted-by":"crossref","unstructured":"Morelli A, Ertmer C, Rehberg S, et al. Phenylephrine versus norepinephrine for initial hemodynamic support of patients with septic shock: a randomized, controlled trial.\n                      Crit Care\n                      2008; 12: R143.","DOI":"10.1186\/cc7121"},{"key":"bibr30-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1186\/cc7990"},{"key":"bibr31-1751143715620203","doi-asserted-by":"crossref","unstructured":"Myburgh JA, Higgins A, Jovanovska A, et al. A comparison of epinephrine and norepinephrine in critically ill patients.\n                      Intensive Care Med\n                      2008; 34: 2226\u20132234.","DOI":"10.1007\/s00134-008-1219-0"},{"key":"bibr32-1751143715620203","doi-asserted-by":"crossref","unstructured":"Oliveira S, Dessa F, Rocha C, et al. Early Vasopressin Application in Shock study.\n                      Crit Care\n                      2014; 18(Suppl 1): 158.","DOI":"10.1186\/cc13348"},{"key":"bibr33-1751143715620203","doi-asserted-by":"crossref","unstructured":"Patel BM, Chittock DR, Russell JA, et al. Beneficial effects of short-term vasopressin infusion during severe septic shock.\n                      Anesthesiology\n                      2002; 96: 576\u2013582.","DOI":"10.1097\/00000542-200203000-00011"},{"key":"bibr34-1751143715620203","doi-asserted-by":"crossref","unstructured":"Patel GP, Grahe JS, Sperry M, et al. 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Terlipressin in the treatment of late phase catecholamine-resistant septic shock.\n                      Hepatogastroenterology\n                      2012; 59: 1043\u20131047."},{"key":"bibr36-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1186\/cc13351"},{"key":"bibr37-1751143715620203","doi-asserted-by":"publisher","DOI":"10.4103\/0972-5229.37713"},{"key":"bibr38-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.2639"},{"key":"bibr39-1751143715620203","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-005866"}],"container-title":["Journal of the Intensive Care Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1751143715620203","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1751143715620203","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1751143715620203","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:55:06Z","timestamp":1777460106000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1751143715620203"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12,17]]},"references-count":39,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,5]]}},"alternative-id":["10.1177\/1751143715620203"],"URL":"https:\/\/doi.org\/10.1177\/1751143715620203","relation":{},"ISSN":["1751-1437"],"issn-type":[{"value":"1751-1437","type":"print"}],"subject":[],"published":{"date-parts":[[2015,12,17]]}}}