Recommandation de pratique clinique de la Société canadienne de soins intensifs: utilisation de vasopressine et d’analogues de la vasopressine chez l’adulte en état critique souffrant de choc distributif
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Recommandation de pratique clinique de la Société canadienne de soins intensifs : utilisation de vasopressine et d’analogues de la vasopressine chez l’adulte en état critique souffrant de choc distributif. / Honarmand, Kimia; Um, Kevin John; Belley-Côté, Emilie P.; Alhazzani, Waleed; Farley, Chris; Fernando, Shannon M.; Fiest, Kirsten; Grey, Donna; Hajdini, Edita; Herridge, Margaret; Hrymak, Carmen; Møller, Morten Hylander; Kanji, Salmaan; Lamontagne, François; Lauzier, François; Mehta, Sangeeta; Paunovic, Bojan; Singal, Rohit; Tsang, Jennifer Ly; Wynne, Christine; Rochwerg, Bram.
In: Canadian Journal of Anesthesia, Vol. 67, No. 3, 2020, p. 369-376.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Recommandation de pratique clinique de la Société canadienne de soins intensifs
T2 - utilisation de vasopressine et d’analogues de la vasopressine chez l’adulte en état critique souffrant de choc distributif
AU - Honarmand, Kimia
AU - Um, Kevin John
AU - Belley-Côté, Emilie P.
AU - Alhazzani, Waleed
AU - Farley, Chris
AU - Fernando, Shannon M.
AU - Fiest, Kirsten
AU - Grey, Donna
AU - Hajdini, Edita
AU - Herridge, Margaret
AU - Hrymak, Carmen
AU - Møller, Morten Hylander
AU - Kanji, Salmaan
AU - Lamontagne, François
AU - Lauzier, François
AU - Mehta, Sangeeta
AU - Paunovic, Bojan
AU - Singal, Rohit
AU - Tsang, Jennifer Ly
AU - Wynne, Christine
AU - Rochwerg, Bram
PY - 2020
Y1 - 2020
N2 - Purpose: Hemodynamic management of adults with distributive shock often includes the use of catecholamine-based vasoconstricting medications. It is unclear whether adding vasopressin or vasopressin analogues to catecholamine therapy is beneficial in the management of patients with distributive shock. The purpose of this guideline was to develop an evidence-based recommendation regarding the addition of vasopressin to catecholamine vasopressors in the management of adults with distributive shock. Methods: We summarized the evidence informing this recommendation by updating a recently published meta-analysis. Then, a multidisciplinary panel from the Canadian Critical Care Society developed the recommendation using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Results: The updated systematic review identified 25 randomized controlled trials including a total of 3,737 patients with distributive shock. Compared with catecholamine therapy alone, the addition of vasopressin or its analogues was associated with a reduced risk of mortality (relative risk [RR], 0.91; 95% confidence interval [CI], 0.85 to 0.99; low certainty), reduced risk of atrial fibrillation (RR, 0.77; 95% CI, 0.67 to 0.88; high certainty), and increased risk of digital ischemia (RR, 2.56; 95% CI, 1.24 to 5.25; moderate certainty). Conclusions: After considering certainty in the evidence, values and preferences, cost, and other factors, the expert guideline panel suggests using vasopressin or vasopressin analogues in addition to catecholamines over catecholamine vasopressors alone for the management of distributive shock (conditional recommendation, low certainty evidence).
AB - Purpose: Hemodynamic management of adults with distributive shock often includes the use of catecholamine-based vasoconstricting medications. It is unclear whether adding vasopressin or vasopressin analogues to catecholamine therapy is beneficial in the management of patients with distributive shock. The purpose of this guideline was to develop an evidence-based recommendation regarding the addition of vasopressin to catecholamine vasopressors in the management of adults with distributive shock. Methods: We summarized the evidence informing this recommendation by updating a recently published meta-analysis. Then, a multidisciplinary panel from the Canadian Critical Care Society developed the recommendation using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Results: The updated systematic review identified 25 randomized controlled trials including a total of 3,737 patients with distributive shock. Compared with catecholamine therapy alone, the addition of vasopressin or its analogues was associated with a reduced risk of mortality (relative risk [RR], 0.91; 95% confidence interval [CI], 0.85 to 0.99; low certainty), reduced risk of atrial fibrillation (RR, 0.77; 95% CI, 0.67 to 0.88; high certainty), and increased risk of digital ischemia (RR, 2.56; 95% CI, 1.24 to 5.25; moderate certainty). Conclusions: After considering certainty in the evidence, values and preferences, cost, and other factors, the expert guideline panel suggests using vasopressin or vasopressin analogues in addition to catecholamines over catecholamine vasopressors alone for the management of distributive shock (conditional recommendation, low certainty evidence).
U2 - 10.1007/s12630-019-01546-x
DO - 10.1007/s12630-019-01546-x
M3 - Tidsskriftartikel
C2 - 31797234
AN - SCOPUS:85075978130
VL - 67
SP - 369
EP - 376
JO - Canadian Journal of Anaesthesia
JF - Canadian Journal of Anaesthesia
SN - 0832-610X
IS - 3
ER -
ID: 260196107