The findings of the VANISH trial were published in JAMA yesterday. The findings show that vasopressin can be used as an alternative to typically used adrenaline-like drugs to improve blood pressure in septic shock.
Current practice is to treat all patients with antibiotics and powerful adrenaline-like drugs to support the heart and blood pressure. However, we know these adrenaline-like drugs have side-effects.
Fewer patients treated needed support of kidney machines
National Institute for Health Research (NIHR) funded Research Professor Anthony Gordon conducted the VANISH trial, which is also supported by the Intensive Care Foundation. The trial compared early vasopressin use to noradrenaline.
Although the use of vasopressin did not show an improvement in the main outcome measure of the trial, which was a combination of survival and duration of kidney failure, it did reduce the use of adrenaline-like drugs and fewer patients treated with vasopressin needed the support of kidney machines.
Call for personalised drug strategy
NIHR Research Professor Anthony Gordon, the Chief Investigator of the trial and Director of Research for the Intensive Care Foundation, said that “it is important for clinicians to know that they can use vasopressin early in septic shock and that for some patients it may prevent the need for dialysis”.
“Looking forward we now need to investigate ways to rapidly identify those patients who will benefit most so that appropriate treatment can be started early”, he also said.
Stephen Brett, President of the Intensive Care Society, calls for more research on drug treatment in intensive care. “It is time to look at a more personalised drug strategy for patients with sepsis to allow clinicians to treat patients as individuals and both to improve their chances of survival and their long term recovery and health”, says Dr Brett, and continues ”this study forms an important part of our national research effort in this area. The Intensive Care Foundation has worked with patients, their families and the whole professional community to determine jointly our future research priorities”.
Read more on the JAMA website.