Claimed effect · Vasopressin

Does Vasopressin help with mortality in septic shock?

A
Grade A — established in humans1 large RCT (VASST, n=778) · effect size: not measurable
Short answerEstablished in humans. 1 large RCT (VASST, n=778) point the same way: no measurable effect, or none yet shown. VASST randomised 778 patients with septic shock to vasopressin or noradrenaline infusion in addition to open-label vasopressors. There was no difference in 28-day or 90-day mortality. A large, well-conducted negative trial, and the reason vasopressin is a catecholamine-sparing adjunct rather than a survival intervention.

What the studies show

VASST randomised 778 patients with septic shock to vasopressin or noradrenaline infusion in addition to open-label vasopressors. There was no difference in 28-day or 90-day mortality. A large, well-conducted negative trial, and the reason vasopressin is a catecholamine-sparing adjunct rather than a survival intervention.

“There was no significant difference between the vasopressin and norepinephrine groups in the 28-day mortality rate (35.4% and 39.3%, respectively; P=0.26) or in 90-day mortality (43.9% and 49.6%, respectively; P=0.11).”

Verbatim, from the abstractRussell JA, Walley KR, Singer J, et al. Vasopressin versus norepinephrine infusion in patients with septic shock (VASST). N Engl J Med, 2008;358:877–887

Several well-run randomised trials in people, pointing the same way. You can plan around this. It still says nothing about whether the effect is worth the side effects for you.

  1. 1
    Russell JA, Walley KR, Singer J, et al. Vasopressin versus norepinephrine infusion in patients with septic shock (VASST).N Engl J Med, 2008;358:877–887778 randomised; no difference in 28-day or 90-day mortality.

In context

Vasopressin is the nine-amino-acid pituitary hormone that constricts blood vessels and concentrates urine, used in intensive care as a second vasopressor in septic shock. In VASST, the 778-patient randomised trial that defined its role, adding vasopressin to noradrenaline did not reduce 28-day or 90-day mortality. It is approved in the US as Vasostrict for raising blood pressure in adults with vasodilatory shock, given by intravenous infusion, and is hospital-use only.

Vasopressin is approved (rx). Legal status differs by country — see the regulation section or the jurisdiction pages.

Questions

Is Vasopressin proven to help with mortality in septic shock?
Yes, as far as human trials can show it: 1 large RCT (VASST, n=778). LYO grades this outcome A.
What studies are behind the grade?
VASST randomised 778 patients with septic shock to vasopressin or noradrenaline infusion in addition to open-label vasopressors. There was no difference in 28-day or 90-day mortality. A large, well-conducted negative trial, and the reason vasopressin is a catecholamine-sparing adjunct rather than a survival intervention.
Is Vasopressin approved for this?
Vasopressin is an approved medicine (Approved (Rx)); whether this particular outcome is a licensed indication is stated on the compound page's regulation section.

Other outcomes for Vasopressin

Written and maintained by LYO Research — how pages are written and checked. Reviewed 29 October 2026. Grades count human evidence only; see how LYO grades. Not medical advice. Correct this page →