Summary

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• This summary is based on the review of 12 systematic review(s)/meta-analysis(es). ^[1-12]
• Vasoplegic Shock: No significant difference in mortality observed with vasopressin compared to norepinephrine (odds ratio (OR) = 1.60; confidence interval (CI) 0.47-5.50) or placebo; non-significant reduction in hospital stay length with vasopressin.
• Hemorrhagic Shock: Mortality rates showed no significant difference between those treated with vasopressin receptor agonists and untreated patients (relative risk (RR)= 1.17; CI 0.67-2.08).
• Septic Shock: No significant difference in 28-day mortality (OR = 1.07; CI 0.80-1.44) or ICU (intensive care unit) mortality (OR = 0.74; CI 0.21-2.67) between vasopressin and norepinephrine, but lower odds of renal replacement therapy (RRT) requirement in vasopressin-treated patients (OR = 0.68; CI 0.47-0.98); early initiation within 6 hours of shock onset reduced RRT use (OR = 0.63; CI 0.44-0.88).
• Cardiac Surgery-induced Vasoplegic Shock: No significant differences in 30-day mortality, stroke, ventricular arrhythmias, or duration of mechanical ventilation between vasopressin and other pressors; conflicting evidence on acute kidney injury, atrial arrhythmias, duration of vasopressor use, and ICU stay length.
• Digital Ischemia: Increased risk observed with vasopressin or its analogs (RR = 2.65; CI 1.26-5.56).
• Hypotension in Septic Shock: Higher incidence of hypotension when vasopressin is withdrawn before norepinephrine (OR = 0.3; CI 0.10-0.86); discontinuing norepinephrine first results in lower hypotension rates compared to discontinuing vasopressin first (OR = 0.35; CI 0.16-0.76).
• Other Adverse Events: No significant differences in total adverse events, arrhythmia, acute myocardial infarction, cardiac arrest, acute mesenteric ischemia, ICU/hospital length of stay, and mechanical ventilation duration.
• There is no population type or subgroup information available in the reviewed studies.