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Critical Care

Open Access

Vasopressin versus norepinephrine for the management of septic shock in cancer patients

  • C Zambolim1,
  • D Nagaoka1,
  • J Fukushima1,
  • C Park1,
  • J Carneiro1,
  • E Osawa1,
  • J Almeida1,
  • S Zefferino1,
  • F Galas1 and
  • L Hajjar1
Critical Care201418(Suppl 1):P161

Published: 17 March 2014


Blood PressureCancer PatientMortality RateNorepinephrineCatecholamine


Patients with septic shock die mainly due to refractory shock. Vasopressin is commonly used as an adjunct to catecholamines to support blood pressure in refractory septic shock, but its effect on mortality is unknown. We hypothesized that vasopressin as compared with norepinephrine would decrease mortality among cancer patients with septic shock.


In this, randomized, double-blind trial, we assigned patients who had cancer and septic shock and needed a vasopressor to receive norepinephrine or vasopressin in addition to open-label vasopressors. All vasopressor infusions were titrated and tapered according to protocols to maintain a target blood pressure. The primary endpoint was the mortality rate 28 days after the start of infusions.


A total of 107 patients underwent randomization in this first part of trial, and were infused with the study drug (53 patients received vasopressin, and 54 norepinephrine), and were included in the analysis. There was no significant difference between the vasopressin and norepinephrine groups in the 28-day mortality rate (67.9 and 58.5%, respectively; P = 0.31). There were no significant differences in the overall rates of serious adverse events (5.3% and 5.5%, respectively; P = 1.00).


Vasopressin did not reduce mortality rates as compared with norepinephrine among patients with cancer and septic shock who were treated with catecholamine vasopressors.



Clinical Trials number: NCT01718613.

Authors’ Affiliations

Instituto do Cancer do Estado de São Paulo, Brazil


© Zambolim et al.; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.