6/30/23, 12:11 AM VASST Pathway Feedback Search Clinical Topics Home Studies VASST VASST Disease Sepsis and septic shock Trial question What is the role of vasopressin among patients with septic shock who were treated with catecholamine vasopressors? Study design Multi-center Double blinded RCT Population Characteristics of study participants 39.0% female N = 778 61.0% male 778 patients (304 female, 475 male) Inclusion criteria: patients who had septic shock and were receiving a minimum of 5 g of norepinephrine per minute Key exclusion criteria: anticipated death in 12 months, > 24 hours since the meeting of inclusion criteria, pregnancy, chronic heart disease, unstable angina or myocardial infarction within the previous 30 days, acute mesenteric ischemia, severe hyponatremia, Raynaud's phenomenon, systemic sclerosis, TBI Interventions N=396 vasopressin (at a dose of 0.01-0.03 U/min plus open-label vasopressors) N=382 norepinephrine (at a dose of 5-15 g/min plus open-label vasopressors) Primary outcome Death at day 28 https://web.pathway.md/studies/recTCyAk6bibwLXlY 1/2 6/30/23, 12:11 AM VASST Pathway 39.3 % 39.3 35.4 29.5 % 19.6 % 9.8 % No significant difference 0.0 % Vasopressin Norepinephrine No significant difference in death at day 28 (35.4% vs. 39.3%; RR 0.9, 95% CI 0.75 to 1.08) Secondary outcomes No significant difference in death at day 90 (43.9% vs. 49.6%; RR 0.88, 95% CI 0.76 to 1.03) No significant difference in length of stay in the ICU (15 days vs. 16 days; AD -1 days, 95% CI -2.33 to 0.33) No significant difference in length of stay in the hospital (27 days vs. 26 days; AD 1 days, 95% CI -0.63 to 2.63) Safety outcomes No significant difference in serious adverse events. Significant differences in cardiac arrest (0.8% vs. 2.1%), digital ischemia (2.0% vs. 0.5%). Conclusion In patients who had septic shock and were receiving a minimum of 5 g of norepinephrine per minute, vasopressin was not superior to norepinephrine with respect to death at day 28. Reference Russell JA, Walley KR, Singer J et al. Vasopressin versus norepinephrine infusion in patients with septic shock. N Engl J Med. 2008 Feb 28;358(9):877-87. Open reference URL https://web.pathway.md/studies/recTCyAk6bibwLXlY 2/2