Need and amount of vasopressor agents.
Regarding the need for vasopressors, pooling the four RCTs (39) (40)
(41) (42), an RR of 0.79 (95% CI= 0.51 to 1.21) was obtained, with a
considerable heterogeneity (I2=89%). In one of the
studies the need for vasoactive agents was not predefined as outcomes
and the authors reported that all participants eventually required
vasopressors (42). Following a sensitivity analysis, excluding this
trial, and pooling the remaining RCTs deliver a RR of 0.76 (95%CI= 0.61
to 0.94) with negligible heterogeneity (I2 = 1%),
shown in Figure 10 (Forest plot of comparison: Sensitivity
analysis, outcome 1.4 Need for vasopressors agents). Concerning the
amount of vasopressors, only two clinical trials reported this outcome.
(40) (42). In one of the RCTs (40), the total amount (mg) was
significantly lower in the paraffin oil group compared to the control
group (mean of 46.5 ± 16.7 mg vs. 68.4 ± 25.4 mg respectively; p=
0.016). On the contrary, in the other trial, the amounts were higher in
the intervention group, but with no significant difference (42).
Contradictory results have been attributed to the higher rate of
morality in the control
group.