title: Early vasopressin reduces incidence of new onset arrhythmias.
abstract: OBJECTIVE
  The objective of this study was to determine the effect of early vs late vasopressin therapy on catecholamine dose and duration.
  
  
  METHODS
  We conducted a single-center, retrospective chart review of adult patients admitted to the medical intensive care unit between January 2010 and December 2011 with septic shock requiring catecholamine and vasopressin therapy. Patients were included in the early group if vasopressin was initiated within 6 hours and the late group if vasopressin was initiated between 6 and 48 hours of catecholamine(s).
  
  
  RESULTS
  Duration of catecholamine and vasopressin therapy was similar between the 35 patients in the early group and the 36 in the late group. Vasopressin therapy was associated with a decrease in catecholamine requirements in both groups. Early vasopressin was associated with fewer new onset arrhythmias (37.1% vs 62.9%, P<.001). There was no difference in mortality, hospital, or intensive care unit length of stay between the early and late group vasopressin groups (88.6% vs 88.9%, P=1; 14 vs 10 days, P=.48; 9 vs 7 days, P=.71, respectively).
  
  
  CONCLUSIONS
  Early initiation of vasopressin therapy in adult critically ill patients with septic shock was associated with no difference in total catecholamine requirements but decreased incidence of new onset arrhythmias.
authors.affiliation: Department of Pharmacy Services, Brigham and Women's Hospital, Boston, MA. Electronic address: dpreardon@partners.org.
authors.forename: David P
authors.initials: DP
authors.lastname: Reardon
authors.affiliation: Department of Pharmacy Services, Brigham and Women's Hospital, Boston, MA.
authors.forename: Jeremy R
authors.initials: JR
authors.lastname: DeGrado
authors.affiliation: Department of Pharmacy Services, Brigham and Women's Hospital, Boston, MA.
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Anger
authors.affiliation: Department of Pharmacy Services, Brigham and Women's Hospital, Boston, MA.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Szumita
mesh_terms: D000368:Aged; D001127:Arginine Vasopressin / Q000008:administration & dosage; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000517:prevention & control*; D002395:Catecholamines / Q000008:administration & dosage* / Q000009:adverse effects; D016638:Critical Illness; D004334:Drug Administration Schedule; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012772:Shock, Septic / Q000188:drug therapy* / Q000401:mortality; D014667:Vasopressins / Q000008:administration & dosage*
chemical_list: D002395:Catecholamines; D014667:Vasopressins; D001127:Arginine Vasopressin
keywords: Catecholamine; Sepsis; Septic shock; Vasopressin