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 2 Clinical outcomes

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

Outcome	DEX (n = 44)	Usual care (n = 39)	Estimate (95%CI)	p value
Difference in medians
NEq dose^a, μg/kg/min	0.03 [0.01, 0.07]	0.04 [0.01, 0.16]	− 0.01 [− 0.06, 0.04]	0.17
Noradrenaline dose^a, μg/kg/min	0.03 [0.01, 0.07]	0.05 [0.01, 0.15]	− 0.01 [− 0.06, 0.03]	0.08
Cumulative NEq dose^a, μg/kg/48 h.	1.51 [0.51, 3.60]	2.14 [0.58, 7.78]	− 0.62 [− 3.18, 1.93]	0.19
Peak NEq dose^a, μg/kg/min	0.12 [0.05, 0.20]	0.16 [0.08, 0.32]	− 0.03 [− 0.12, 0.06]	0.24
Change in NEq dose from baseline to peak level^a, μg/kg/min	0.05 [0.01, 0.12]	0.05 [0.01, 0.14]	− 0.01 [− 0.06, 0.05]	0.61
Total duration of vasopressor support^b, h	51.6 [18.3, 99.7]	45.7 [19.6, 159.0]	3.1 [− 30.7, 36.9]	0.72
Survivors (n = 67)	35.6 [18.3, 69.4]	40.3 [22.2, 75.6]	− 3.5 [− 30.1, 23.1]	0.64
Non-survivors (n = 16)	186.0 [59.0, 311.0]	70.4 [19.4, 168.0]	19.8 [− 173.1, 212.6]	0.42
Duration of invasive ventilation^b, days	2.2 [1.1, 5.9]	2.8 [1.2, 9.6]	− 0.5 [− 3.8, 2.8]	0.60
Hospital length of stay^b, days	15.5 [9.4, 24.4]	13.2 [7.7, 21.0]	− 2.2 [− 8.5, 4.1]	0.30
ICU length of stay^b, days	4.2 [2.7, 10.2]	4.7 [3.0, 11.3]	− 0.4 [− 3.4, 2.6]	0.67
Survivors (n = 67)	4.1 [3.0, 9.2]	4.3 [3.2, 7.0]	− 0.1 [− 2.7, 2.3]	0.70
Non-survivors (n = 16)	8.9 [2.4, 16.2]	8.3 [0.8, 11.3]	− 3.3 [− 16.2, 9.6]	0.87
Odds ratio (95% CI)
Patients alive and vasopressor-free at 48 h after randomization	20 (45.5)	18 (46.2)	0.97 (0.41–2.31)	0.95
ICU mortality	6 (13.6)	10 (25.6)	0.46 (0.15–1.41)	0.17
Hospital mortality	9 (20.5)	12 (30.8)	0.58 (0.21–1.57)	0.28
Day 90 mortality	12 (27.3)	13 (34.2)	0.72 (0.28–1.85)	0.50

Categorical values are expressed as numbers (%). Continuous variables are presented as medians [IQR]
DEX dexmedetomidine, IQR interquartile range, 95% CI 95% confidence interval, ICU intensive care unit, MAP mean arterial pressure, NEq noradrenaline equivalents
^aIn the first 48 h after randomization
^bWithin principal hospital admission, measured from randomization

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