Use of vasopressors for septic shock in the neonatal intensive care unit

ABSTRACT OBJECTIVE To describe outcomes for infants in the neonatal intensive care unit with septic shock based on the vasopressor administered. METHODS This is a multicenter cohort study of

infants with an episode of septic shock. We evaluated the primary outcomes of mortality and pressor-free days alive in the first week after shock using multivariable logistic and Poisson

regressions. RESULTS We identified 1592 infants. Mortality was 50%. Dopamine was the most used vasopressor (92% of episodes) and hydrocortisone was co-administered with a vasopressor in 38%

of episodes. Compared to infants treated with dopamine alone, adjusted odds of mortality were significantly higher for those treated with epinephrine alone (aOR 4.7 [95% CI: 2.3–9.2]).

Adjuvant hydrocortisone was associated with significantly lower adjusted odds of mortality (aOR 0.60 [0.42–0.86]) CONCLUSIONS The use of epinephrine as either a solo agent or in combination

therapy was associated with significantly worse outcomes, while adjuvant hydrocortisone was associated with decreased mortality. Access through your institution Buy or subscribe This is a

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HYDROCORTISONE VERSES PLACEBO IN NEONATAL SHOCK- A DOUBLE BLIND RANDOMIZED CONTROLLED TRIAL Article 13 February 2025 VASOPRESSIN AS ADJUNCTIVE THERAPY IN PULMONARY HYPERTENSION ASSOCIATED

WITH REFRACTORY SYSTEMIC HYPOTENSION IN TERM NEWBORNS Article 04 July 2024 THE USE OF SUPPLEMENTAL HYDROCORTISONE IN THE MANAGEMENT OF PERSISTENT PULMONARY HYPERTENSION OF THE NEWBORN

Article 15 February 2021 DATA AVAILABILITY The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. CODE

AVAILABILITY The computer code and Stata do-files used to generate the results of the manuscript are available from the corresponding author on reasonable request. REFERENCES * Stoll BJ,

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2006;34:1589–96. Article  PubMed  Google Scholar  Download references ACKNOWLEDGEMENTS Erin Campbell, MS, provided editorial review and manuscript submission. Erin Campbell did not receive

compensation for her assistance, apart from her employment at the institution where this research was conducted. Carol Hill, PhD, provided informatics assistance with data procurement from

Pediatrix. The authors would like to thank Duke Pediatric Research Scholars. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Pediatrics, Duke University School of Medicine,

Durham, NC, USA Henry P. Foote, Rachel G. Greenberg & Christoph P. Hornik * Department of Economics, Clemson University, Clemson, SC, USA Daniel K. Benjamin * Duke Clinical Research

Institute, Durham, NC, USA Rachel G. Greenberg & Christoph P. Hornik * Pediatrix Medical Group, Inc., Sunrise, FL, USA Reese H. Clark Authors * Henry P. Foote View author publications

You can also search for this author inPubMed Google Scholar * Daniel K. Benjamin View author publications You can also search for this author inPubMed Google Scholar * Rachel G. Greenberg

View author publications You can also search for this author inPubMed Google Scholar * Reese H. Clark View author publications You can also search for this author inPubMed Google Scholar *

Christoph P. Hornik View author publications You can also search for this author inPubMed Google Scholar CONTRIBUTIONS All authors made substantial contributions to the conception or design

of the work, or the acquisition, analysis, or interpretation of data. HPF drafted the work, all authors revised it critically for important intellectual content. All authors approved the

final version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are

appropriately investigated and resolved. CORRESPONDING AUTHOR Correspondence to Christoph P. Hornik. ETHICS DECLARATIONS COMPETING INTERESTS RGG received support from the industry for

research services (https://dcri.org/about-us/conflict-of-interest/). The authors have no other conflicts of interest relevant to this article to disclose. ETHICS APPROVAL AND CONSENT TO

PARTICIPATE We obtained institutional review board approval from the Duke University Health System IRB with a waiver of informed consent for our study, protocol Pro00112607. The study was

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for septic shock in the neonatal intensive care unit. _J Perinatol_ 43, 1274–1280 (2023). https://doi.org/10.1038/s41372-023-01667-8 Download citation * Received: 09 January 2023 * Revised:

21 March 2023 * Accepted: 24 March 2023 * Published: 13 April 2023 * Issue Date: October 2023 * DOI: https://doi.org/10.1038/s41372-023-01667-8 SHARE THIS ARTICLE Anyone you share the

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