Vasopressin and terlipressin in adult vasodilatory shock 英文参考文献.docVIP

Polito et al. Critical Care 2012, 16:470 /content/16/6/470 LET TER Vasopressin and terlipressin in adult vasodilatory shock Angelo Polito* , Emilio Parisini , Zaccaria Ricci , Sergio Picardo and Djillali Annane 1 2 1 1 3 See related research by Serpa Neto et al., /content/16/4/R154 We have read with interest the study by Serpa Neto and bypass and ventricular assist device placement, a quite colleagues showing that vasopressin use in vasodilatory unique patient population with regards to the patho- shock is associated with reduced mortality [1]. However, we believe there are three aspects that need clari? cation. In relation to the paper recently published by our group on the same topic, the authors correctly state that ‘we only analyzed adult patients because pediatric shock has physio logy of shock [3]. Argenziano and colleagues’ study was also carried out in a time of very di? erent standards of intensive care (1997), compared with all other studies that were performed in the mid to late 2000s. Moreover, the ‘reduction in norepinephrine require- a much lower mortality that adult shock and this may ment’ presented by the authors is not in con? ict with our “contaminate” the overall results’ [1]. For the main ? nding of a signi? cant inverse relation between the analysis in our article, we computed data from six ran- vasopressin dose and the norepinephrine dose[2]. dom ized trials exploring use of vasopressin/terlipressin only in adults [2]. Mortality in children was examined in a separate subgroup analysis. On a side note, we believe the authors’ choice of using a ? xed-e? ect model to compute a pooled estimate of the relative risk is questionable because it is based on