The effect of dexmedetomidine on vasopressor requirements in patients with septic shock: a subgroup analysis of the Sedation Practice in Intensive Care Evaluation [SPICE III] Trial

Cioccari, Luca; Luethi, Nora; Bailey, Michael; Shehabi, Yahya; Howe, Belinda; Messmer, Anna S.; Proimos, Helena K.; Peck, Leah; Young, Helen; Eastwood, Glenn M.; Merz, Tobias M.; Takala, Jukka; Jakob, Stephan M.; Bellomo, Rinaldo

doi:10.1186/s13054-020-03115-x

Critical Care

Table 1 Patient characteristics at baseline

From: The effect of dexmedetomidine on vasopressor requirements in patients with septic shock: a subgroup analysis of the Sedation Practice in Intensive Care Evaluation [SPICE III] Trial

Variable	DEX (n = 44)	Usual care (n = 39)	p value
Study site—no. (%)			0.77
Australia	20 (45.5)	19 (48.7)
Switzerland	24 (54.5)	20 (51.3)
Age (years)—mean ± SD	67.7 ± 12.4	62.9 ± 16.8	0.14
Male sex—no. (%)	29 (65.9)	28 (71.8)	0.56
Weight (kg)—mean ± SD	80.6 ± 17.7	85.3 ± 31.4	0.39
APACHE II score—mean ± SD	24.9 ± 6.7	25.3 ± 7.0	0.77
Chronic health conditions—no.(%)
Diabetes mellitus treated with insulin	4 (9.1)	2 (5.1)	0.68
Chronic hemodialysis	1 (2.3)	1 (2.6)	> 0.99
Liver cirrhosis	1 (2.3)	1 (2.6)	> 0.99
Portal hypertension	1 (2.3)	3 (7.7)	0.34
Immunosuppression by disease	1 (2.3)	2 (5.1)	0.60
Immunosuppression by therapy	2 (4.5)	3 (7.7)	0.66
ICU admission source—no. (%)			0.91
Emergency department	13 (29.5)	13 (33.3)
Hospital ward	18 (40.9)	13 (33.3)
Operating room	7 (15.9)	9 (23.1)
Another ICU	1 (2.6)	1 (2.3)
Other hospitals	5 (11.4)	3 (7.7)
Surgical admission—no. (%)	8 (18.2)	10 (25.6)	0.41
Primary site of infection—no. (%)
Respiratory	26 (59.1)	18 (46.2)	0.24
Gastrointestinal	10 (22.7)	14 (35.9)	0.19
Skin/soft tissues/bone	3 (6.8)	4 (10.3)	0.7
Urinary	1 (2.3)	1 (2.6)	> 0.99
Blood	2 (4.5)	0 (0.0)	0.5
Other	2. (4.5)	2 (5.1)	> 0.99
Organ-specific SOFA score—median [IQR]
Cardiovascular	3 [3, 3]	3 [3, 4]	0.06
Respiratory	2 [2, 3]	2 [2, 3]	0.80
Renal	1 [0, 3]	2 [0, 3]	0.27
Coagulation	0 [0, 0]	1 [0, 2]	0.006
Liver	0 [0, 1]	1 [0, 2]	0.14
NEq (μg/kg/min)—median [IQR]	0.05 [0.03, 0.10]	0.07 [0.02, 0.16]	0.32
Continuous vasoactive drugs at baseline—no. (%)
Noradrenaline	38 (86.4)	35 (89.7)	0.64
Adrenaline	4 (9.1)	2 (5.1)	0.68
Dobutamine	1 (2.3)	3 (7.7)	0.34
Vasopressin	1 (2.3)	2 (5.1)	0.60
Sedative and analgesic drugs at baseline—no. (%)
Propofol	31 (73.8)	33 (86.8)	0.15
Fentanyl	26 (61.9)	30 (78.9)	0.10
Midazolam	20 (47.6)	16 (42.1)	0.62
Morphine	5 (11.9)	3 (7.9)	0.55
Ketamine	2 (4.8)	2 (5.3)	> 0.99
Other treatments at baseline—no. (%)
Continuous renal replacement therapy	10 (22.7)	13 (33.3)	0.28
Hydrocortisone^a for septic shock	19 (43.2)	16 (41.0)	0.84
Physiological variables
Fluid balance at baseline (ml)—median [IQR]	876 [− 21, 2600]	621 [− 67, 2378]	0.88
Heart rate (beats/min)—median [IQR]	85 [74, 99.5]	95 [80, 105]	0.10
Mean arterial pressure (mmHg)—mean ± SD	65.4 ± 8.35	66.1 ± 8.85	0.71
Creatinine level (mg/dl)—median [IQR]	1.23 [0.78, 2.12]	1.76 [1.14, 2.34]	0.044
Creatinine level (μmol/l)—median [IQR]	109 [69, 187]	156 [101, 207]	0.044
Lactate level (mmol/l)—median [IQR]	1.8 [1.4, 2.7]	1.95 [1.4, 3.1]	0.58
RASS prior randomization—median [IQR]	− 3 [− 4, 1]	− 3 [− 4, − 2]	0.69
Time from ICU admission to randomization (h)—median [IQR]	8.8 [3.6, 12.4]	11.1 [4.7, 19.1]	0.22
Time from ICU admission to start of vasopressors (h)—median [IQR]	1.4 [0.5, 3.5]	2.7 [0.4, 5.1]	0.39

Categorical values are expressed as numbers (%). Continuous variables are presented as means ± SD if normally distributed, otherwise as medians [IQR]
APACHE Acute Physiology And Chronic Health Evaluation, DEX dexmedetomidine, ICU intensive care unit, NEq noradrenaline equivalents, RASS: Richmond Agitation-Sedation Scale, SOFA Sequential Organ Failure Assessment
^aIn the first 48 h after randomization

Back to article page

ISSN: 1364-8535

Contact us

Submission enquiries: journalsubmissions@springernature.com