Santos AGR, Castillo GRA, Roque AEI, Muñetón AJA, Rodríguez BE, Venegas ZGE, Varela ME

Language: Spanish
References: 14
Page: 465-468
PDF size: 247.39 Kb.

ABSTRACT

Introduction: in the face of the development of septic shock, much has been studied about when to use vasopressors, steroids and antibiotic escalation, but little has been studied about the patient recovering from shock and the ideal vasopressor withdrawal, as well as which one causes fewer complications. Objective: to determine which vasopressor agent is associated with the development of hypotension or arrhythmias when initially withdrawing them. Material and methods: prospective, randomized, single-center study, total sample of 44 patients in a third level hospital, with a diagnosis of septic shock in the process of recovery, of which 22 patients were initially withdrawn from norepinephrine and 22 vasopressin. 59.1% were men (n = 26) and 40.9% women (n = 18), both with comorbidities associated with hypertension and diabetes as the most frequent form. Results: a total of 42 patients were studied, with two of them dying on the third day of discontinuation of amines. The primary outcome was the development of clinically significant hypotension after discontinuation of vasopressin or norepinephrine, as well as the development of arrhythmias. It is observed that hypotension occurred in 19.04% (n = 8) of the total patients, arrhythmias in 23.80% (n = 10); the association of hypotension with norepinephrine was 16.6% (n = 7), vasopressin 2.38% (n = 1); arrhythmias and norepinephrine 14.28% (n = 6), vasopressin 9.52% (n = 4), with a statistical value of p = 0.01(95% CI: –534.09-552.09). Conclusions: the hypothesis that vasopressin is less arrhythmogenic and causes less alteration of the hemodynamic state when initially withdrawn is corroborated, in patients who recover from septic shock.

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