The DOI matches its Crossref record, with a small difference in title or year; 29 of the 29 references it cites were found in a registry or an index.
Effect of Early Vasopressin vs Norepinephrine on Kidney Failure in Patients With Septic Shock: The VANISH Randomized Clinical Trial
Open accessAbstract
IMPORTANCE: Norepinephrine is currently recommended as the first-line vasopressor in septic shock; however, early vasopressin use has been proposed as an alternative. OBJECTIVE: To compare the effect of early vasopressin vs norepinephrine on kidney failure in patients with septic shock. DESIGN, SETTING, AND PARTICIPANTS: A factorial (2×2), double-blind, randomized clinical trial conducted in 18 general adult intensive care units in the United Kingdom between February 2013 and May 2015, enrolling adult patients who had septic shock requiring vasopressors despite fluid resuscitation within a maximum of 6 hours after the onset of shock. INTERVENTIONS: Patients were randomly allocated to vasopressin (titrated up to 0.06 U/min) and hydrocortisone (n = 101), vasopressin and placebo (n = 104), norepinephrine and hydrocortisone (n = 101), or norepinephrine and placebo (n = 103). MAIN OUTCOMES AND MEASURES: The primary outcome was kidney failure-free days during the 28-day period after randomization, measured as (1) the proportion of patients who never developed kidney failure and (2) median number of days alive and free of kidney failure for patients who did not survive, who experienced kidney failure, or both. Rates of renal replacement therapy, mortality, and serious adverse events were secondary outcomes. RESULTS: A total of 409 patients (median age, 66 years; men, 58.2%) were included in the study, with a median time to study drug administration of 3.5 hours after diagnosis of shock. The number of survivors who never developed kidney failure was 94 of 165 patients (57.0%) in the vasopressin group and 93 of 157 patients (59.2%) in the norepinephrine group (difference, -2.3% [95% CI, -13.0% to 8.5%]). The median number of kidney failure-free days for patients who did not survive, who experienced kidney failure, or both was 9 days (interquartile range [IQR], 1 to -24) in the vasopressin group and 13 days (IQR, 1 to -25) in the norepinephrine group (difference, -4 days [95% CI, -11 to 5]). There was less use of renal replacement therapy in the vasopressin group than in the norepinephrine group (25.4% for vasopressin vs 35.3% for norepinephrine; difference, -9.9% [95% CI, -19.3% to -0.6%]). There was no significant difference in mortality rates between groups. In total, 22 of 205 patients (10.7%) had a serious adverse event in the vasopressin group vs 17 of 204 patients (8.3%) in the norepinephrine group (difference, 2.5% [95% CI, -3.3% to 8.2%]). CONCLUSIONS AND RELEVANCE: Among adults with septic shock, the early use of vasopressin compared with norepinephrine did not improve the number of kidney failure-free days. Although these findings do not support the use of vasopressin to replace norepinephrine as initial treatment in this situation, the confidence interval included a potential clinically important benefit for vasopressin, and larger trials may be warranted to assess this further. TRIAL REGISTRATION: clinicaltrials.gov Identifier: ISRCTN 20769191.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Most studies were observational, and there are concerns that de-escalation is used primarily in patients who are getting better, which is why the reported improved short-term mortality should be interpreted with caution (277,279).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [279]
Experimental — accuracy not yet measuredIn the citing paper
“Although there was no difference with respect to kidney injury (RR 0.89; 95% CI 0.72–1.11), vasopressin use reduced the risk of RRT (RR 0.71; 95% CI 0.53–0.97) [354].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [354]
In the citing paper
“There was no significant difference between the vasopressin and norepinephrine groups in 28-day mortality [30.9% vs 27.5%; RR 1.13 (95% CI 0.85–1.51).”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [354]
In the citing paper
“Several meta-analyses suggest decreased mortality in patients with a pressure- and volume-limited strategy for established ARDS [353, 354].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [354]
In the citing paper
“In the ADRENAL [479] study, hydrocortisone was administered for a maximum of seven days or until ICU discharge or death; in APROCCHSS [478] hydrocortisone was administered for seven days; in VANISH [354] 200 mg of hydrocortisone was administered daily for 5 days and then tapered over further 6 days.”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [354]
In the citing paper
“Since then, three large RCTs have been published [354, 478, 479].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [354]
In the citing paper
“The optimal dose, timing of initiation, and duration of corticosteroids remain uncertain; recent RCTs used 200 mg per day of IV hydrocortisone in divided doses [354, 479].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [354]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Bone, R. C., BALK, R. A., Cerra, F. B., Dellinger, R. P., Fein, A. M., Knaus, W. A., Schein, R. M. H., & Sibbald, W. J. (1992) · CHEST Journal · doi:10.1378/chest.101.6.1644 · Cited by 13,335
Vincent, J. L., Moreno, R., Takala, J., Willatts, S., De Mendonça, A., Bruining, H., Reinhart, C. K., Suter, P. M., & Thijs, L. G. (1996) · Intensive Care Medicine · doi:10.1007/bf01709751 · Cited by 11,674
Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock
Dellinger, R. P., Levy, M. M., Rhodes, A., Annane, D., Gerlach, H., Opal, S. M., Sevransky, J. E., Sprung, C. L., Douglas, I. S., Jaeschke, R., et al. (2013) · Critical Care Medicine · doi:10.1097/ccm.0b013e31827e83af · Cited by 9,694
Dellinger, R. P., Levy, M. M., Rhodes, A., Annane, D., Gerlach, H., Opal, S. M., Sevransky, J., Sprung, C. L., Douglas, I. S., Jaeschke, R., et al. (2013) · Intensive Care Medicine · doi:10.1007/s00134-012-2769-8 · Cited by 7,371
Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury
Mehta, R. L., Kellum, J. A., Shah, S. V., Molitoris, B. A., Ronco, C., Warnock, D. G., Levin, A., & the Acute Kidney Injury Network (2007) · Critical Care · doi:10.1186/cc5713 · Cited by 7,046
Dellinger, R. P., Levy, M. M., Carlet, J. M., Bion, J., Parker, M. M., Jaeschke, R., Reinhart, K., Angus, D. C., Brun‐Buisson, C., Beale, R. J., et al. (2007) · Intensive Care Medicine · doi:10.1007/s00134-007-0934-2 · Cited by 6,789
Hydrocortisone Therapy for Patients with Septic Shock
Sprung, C. L., Annane, D., Keh, D., Moreno, R. P., Singer, M., Freivogel, K., Weiss, Y., Benbenishty, J., Kalenka, A., Forst, H., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa071366 · Cited by 2,179
Vasopressin versus Norepinephrine Infusion in Patients with Septic Shock
Russell, J. A., Walley, K. R., Singer, J., Gordon, A. C., Hébert, P. C., Cooper, D. J., Holmes, C. L., Mehta, S., Granton, J. T., Storms, M. M., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa067373 · Cited by 1,924
Self-citationHigh versus low blood-pressure target in patients with septic shock.
Asfar, P., Meziani, F., Hamel, J.-F., Grelon, F., Megarbane, B., Anguel, N., Mira, J.-P., Dequin, P.-F., Gergaud, S., Weiss, N., et al. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1312173 · Cited by 1,239
Vasopressin Deficiency Contributes to the Vasodilation of Septic Shock
Landry, D. W., Levin, H. R., Gallant, E. M., Ashton, R. C., Seo, S., D'Alessandro, D., Oz, M. C., & Oliver, J. A. (1997) · Circulation · doi:10.1161/01.cir.95.5.1122 · Cited by 990
Cited by
Sorted by citations
Items 701–723 of 723
Dumargne, H., Ly, S. H., Louzier, V., Allaouchiche, B., Hammed, A., & Dargent, A. (2026) · Critical Care · doi:10.1186/s13054-026-06160-0
Abbas, H., & Ahmed, A. (2026) · Springer eBooks · doi:10.1007/978-3-032-28643-7_8
Lee, J. K., Vaughan, L. E., Cureton, K. D., & KASHANI, K. B. (2026) · Journal of Critical Care · doi:10.1016/j.jcrc.2026.155713
Discordant Evidence on Corticosteroids in Sepsis: A Meta-Research StudyPreprint
Weibel, S., Duengfelder, H., Pscheidl, T., Krone, M., & Meybohm, P. (2026) · medRxiv · doi:10.64898/2026.08.20.26360343
Rad, N. K., Lakzaei, T., Nakhostin, M., & Soltanmohammadi, S. (2026) · Pneumonia · doi:10.1186/s41479-026-00209-y
Vasopressor weaning in septic shock: Why the field has been asking the wrong question
ZAIDI, S. A., Kapoor, S., & Abdulmajeed, F. (2026) · Journal of Critical Care · doi:10.1016/j.jcrc.2026.155729
Impacto del uso de vasopresina como segundo vasopresor en pacientes con choque séptico
Valle-Torres, C. J., Galicia-Castañeda, N. J., Tapia-Rodríguez, E. R., Herrera-Salgado, J. M., & Gutiérrez-Chavarría, S. A. (2026) · doi:10.35366/124130
Sun, M., Li, Z., & Hu, Y. (2026) · Research Square · doi:10.21203/rs.3.rs-10559528/v1
Shimazui, T., Shimada, T., Oami, T., Endo, A., Yamakawa, K., Tagami, T., Umemura, Y., Shimoyama, K., & Nakada, T. (2026) · Annals of Intensive Care · doi:10.1016/j.aicoj.2026.100157
Alanazi, M. M., Alyami, H. S. Y., Almutairi, M. S. T., Alatawi, F. S. G., Adlan, B. I. A., & Alharthi, F. F. (2026) · doi:10.65759/aszttx19
May, D., Stegall, C. P., & Tyler, G. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-44037-3.00998-2
Reddi, B. A. J. (2026) · Springer eBooks · doi:10.1007/978-3-032-31459-8_2
Cousin, V. L., Deep, A., Jozwiak, M., & Tissières, P. (2026) · Annals of Intensive Care · doi:10.1016/j.aicoj.2026.100168
Management of abdominal sepsis: Principles, pitfalls, and perspectives
Sartelli, M. (2026) · Intensive Care Science · doi:10.1016/j.iics.2026.08.004
Septic shock in the era of precision medicine: rethinking fluids, vasopressors, and immunomodulation
Du, J., Feng, H., Dong, S., Yang, C., Al-Danakh, A., & Zhou, S. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1909143
Zhang, W., Miao, K., Chen, H., Lu, G., Zhou, Z., & Tang, J. (2026) · Frontiers in Pharmacology · doi:10.3389/fphar.2026.1941459
Jia, Z., Zhao, X., Liu, X., & 李小丽 (2026) · Frontiers in Pharmacology · doi:10.3389/fphar.2026.1962609
Chinese Perioperative Septic Shock Investigators for the Chinese Peri-Operative Organ Protection Group, Li, C., Li, H., Zhang, H., Zhang, X., Zhao, B., 朱少俊, Huang, L., 马震俊, Wang, Y., et al. (2026) · JAMA · doi:10.1001/jama.2026.21322
Léone, M., & Russell, J. A. (2026) · Intensive Care Medicine · doi:10.1007/s00134-026-08640-x
Yu, W., Yanjie, Z., Luo, Z., Cai, X.-E., Shao, J., Lin, W., & Xu, J. (2026) · Journal of Intensive Care Medicine · doi:10.1177/08850666261500019
Antcliffe, D. B., Uhle, F., Marshall, D. C., Green, A. D., Gordon, A. C., & Forni, L. G. (2026) · Critical Care Explorations · doi:10.1097/cce.0000000000001496
Self-citationYan, X., Li, M., Yan, C., Dang, Y., Lv, Y., 李同琴, Zhang, J., Wu, Y., & Ma, L. (2026) · Frontiers in Immunology · doi:10.3389/fimmu.2026.1935801
Jin, L., Wu, Y., & Wang, H. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15218213
Metadata
- Authors
- Gordon, A. C., Mason, A. J., Thirunavukkarasu, N., Perkins, G. D., Cecconi, M., Cepkova, M., Pogson, D. G., Aya, H. D., Anjum, A., Frazier, G. J., Santhakumaran, S., Ashby, D., Brett, S. J., & for the VANISH Investigators
- Affiliations
- Imperial College London (GB)
- London School of Hygiene & Tropical Medicine (GB)
- University of Warwick (GB)
- National Health Service (GB)
- Corresponding author
- Gordon, Anthony C.
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2016-08-02
- Volume
- 316
- Issue
- 5
- Pages
- 509
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2489536306
- Semantic Scholar
- 0a2e8f0595aed35457448e71c5f52e2cd0ccb618
- Cited by
- 728
- References
- 29
- Citations by year
- 2026: 77 · 2025: 114 · 2024: 82 · 2023: 69 · 2022: 59 · 2021: 61 · 2020: 67 · 2019: 83 · 2018: 62 · 2017: 40 · 2016: 12
- FWCI
- 61.17
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- University of Brighton Repository (University of Brighton) (publishedVersion, other-oa)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
- Spiral (Imperial College London) (submittedVersion)
- Warwick Research Archive Portal (University of Warwick) (submittedVersion)
- Funders
- University of Portsmouth
- Intensive Care Foundation
- University Hospital Southampton NHS Foundation Trust
- National Institute for Health and Care Research (NF-SI-0514-10139, NIHR/CS/009/007, PB-PG-0610-22350)
- Imperial College London
- Imperial College Healthcare NHS Trust
- Barts Health NHS Trust
- University Hospitals Coventry and Warwickshire NHS Trust
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Keywords
- septic shock, vasopressin, norepinephrine, renal failure, acute kidney injury, vasopressor therapy, cortisol, renal replacement therapy, mortality, intensive care unit patients, fluid resuscitation, serious adverse events, 90-day outcomes
- MeSH terms
- Adult, Aged, Aged, 80 and over, Critical Care, Double-Blind Method, Drug Administration Schedule, Female, Fluid Therapy, United Kingdom, Humans, Hydrocortisone, Intensive Care Units, Male, Middle Aged, Norepinephrine, Shock, Septic, Vasoconstrictor Agents, Vasopressins, Treatment Outcome, Renal Replacement Therapy, Renal Insufficiency
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
