Impact of Adjuvant Use of Midodrine to Intravenous Vasopressors: A Systematic Review and Meta-Analysis
Purpose. To evaluate the efficacy and safety of midodrine use in intensive care units (ICU) to facilitate weaning off intravenous vasopressors (IVV). Methods. We searched PubMed/MEDLINE, Cochrane library, and Google Scholar (inception through October 18th, 2020) for studies evaluating adjuvant use o...
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| Format: | Article |
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Wiley
2021-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2021/5588483 |
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| author | Ahmad Al-Abdouh Sadam Haddadin Atul Matta Ahmad Jabri Mahmoud Barbarawi Waiel Abusnina Qais Radideh Mohammed Mhanna Dante A. Suffredini Erin D. Michos |
| author_facet | Ahmad Al-Abdouh Sadam Haddadin Atul Matta Ahmad Jabri Mahmoud Barbarawi Waiel Abusnina Qais Radideh Mohammed Mhanna Dante A. Suffredini Erin D. Michos |
| author_sort | Ahmad Al-Abdouh |
| collection | DOAJ |
| description | Purpose. To evaluate the efficacy and safety of midodrine use in intensive care units (ICU) to facilitate weaning off intravenous vasopressors (IVV). Methods. We searched PubMed/MEDLINE, Cochrane library, and Google Scholar (inception through October 18th, 2020) for studies evaluating adjuvant use of midodrine to IVV in the ICU. The outcomes of interest were ICU length of stay (LOS), hospital LOS, mortality, IVV reinstitution, ICU readmission, and bradycardia. Estimates were pooled using the random-effects model. We reported effect sizes as standardized mean difference (SMD) for continuous outcomes and risk ratios (RRs) for other outcomes with a 95% confidence interval (CI). Results. A total of 6 studies were found that met inclusion criteria and had sufficient data for our quantitative analysis (1 randomized controlled trial and 5 retrospective studies). A total of 2,857 patients were included: 600 in the midodrine group and 2,257 patients in the control group. Midodrine use was not associated with a significant difference in ICU LOS (SMD 0.16 days; 95% CI −0.23 to 0.55), hospital LOS (SMD 0.03 days; 95% CI −0.33 to 0.0.39), mortality (RR 0.87; 95% CI 0.52 to 1.46), IVV reinstitution (RR 0.47; 95% CI 0.17 to 1.3), or ICU readmission (RR 1.03; 95% CI 0.71 to 1.49) when compared to using only IVV. However, there were higher trends of bradycardia with midodrine use that did not reach significance (RR 7.64; 95% CI 0.23 to 256.42). Conclusion. This meta-analysis suggests that midodrine was not associated with a significant decrease in ICU LOS, hospital LOS, mortality, or ICU readmissions. |
| format | Article |
| id | doaj-art-90f18bc33de44c148b48669cbdc4523d |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-90f18bc33de44c148b48669cbdc4523d2025-02-03T05:49:16ZengWileyCritical Care Research and Practice2090-13052090-13132021-01-01202110.1155/2021/55884835588483Impact of Adjuvant Use of Midodrine to Intravenous Vasopressors: A Systematic Review and Meta-AnalysisAhmad Al-Abdouh0Sadam Haddadin1Atul Matta2Ahmad Jabri3Mahmoud Barbarawi4Waiel Abusnina5Qais Radideh6Mohammed Mhanna7Dante A. Suffredini8Erin D. Michos9Department of Medicine, Ascension Saint Agnes Hospital, Baltimore, MD, USADepartment of Medicine, Ascension Saint Agnes Hospital, Baltimore, MD, USADepartment of Pulmonary, Critical Care and Sleep Medicine, Einstein Medical Center, Philadelphia, PA, USADepartment of Cardiology, MetroHealth Medical Center, Cleveland, OH, USADepartment of Cardiology, University of Connecticut, Farmington, Mansfield, CT, USADepartment of Cardiology, Creighton University School of Medicine, Omaha, NE, USAMidwest Cardiovascular Research Foundation, Davenport, IA, USADepartment of Medicine, University of Toledo, Toledo, OH, USASection of Critical Care, Department of Medicine, Ascension Saint Agnes Hospital, Baltimore, MD, USADivision of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USAPurpose. To evaluate the efficacy and safety of midodrine use in intensive care units (ICU) to facilitate weaning off intravenous vasopressors (IVV). Methods. We searched PubMed/MEDLINE, Cochrane library, and Google Scholar (inception through October 18th, 2020) for studies evaluating adjuvant use of midodrine to IVV in the ICU. The outcomes of interest were ICU length of stay (LOS), hospital LOS, mortality, IVV reinstitution, ICU readmission, and bradycardia. Estimates were pooled using the random-effects model. We reported effect sizes as standardized mean difference (SMD) for continuous outcomes and risk ratios (RRs) for other outcomes with a 95% confidence interval (CI). Results. A total of 6 studies were found that met inclusion criteria and had sufficient data for our quantitative analysis (1 randomized controlled trial and 5 retrospective studies). A total of 2,857 patients were included: 600 in the midodrine group and 2,257 patients in the control group. Midodrine use was not associated with a significant difference in ICU LOS (SMD 0.16 days; 95% CI −0.23 to 0.55), hospital LOS (SMD 0.03 days; 95% CI −0.33 to 0.0.39), mortality (RR 0.87; 95% CI 0.52 to 1.46), IVV reinstitution (RR 0.47; 95% CI 0.17 to 1.3), or ICU readmission (RR 1.03; 95% CI 0.71 to 1.49) when compared to using only IVV. However, there were higher trends of bradycardia with midodrine use that did not reach significance (RR 7.64; 95% CI 0.23 to 256.42). Conclusion. This meta-analysis suggests that midodrine was not associated with a significant decrease in ICU LOS, hospital LOS, mortality, or ICU readmissions.http://dx.doi.org/10.1155/2021/5588483 |
| spellingShingle | Ahmad Al-Abdouh Sadam Haddadin Atul Matta Ahmad Jabri Mahmoud Barbarawi Waiel Abusnina Qais Radideh Mohammed Mhanna Dante A. Suffredini Erin D. Michos Impact of Adjuvant Use of Midodrine to Intravenous Vasopressors: A Systematic Review and Meta-Analysis Critical Care Research and Practice |
| title | Impact of Adjuvant Use of Midodrine to Intravenous Vasopressors: A Systematic Review and Meta-Analysis |
| title_full | Impact of Adjuvant Use of Midodrine to Intravenous Vasopressors: A Systematic Review and Meta-Analysis |
| title_fullStr | Impact of Adjuvant Use of Midodrine to Intravenous Vasopressors: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Impact of Adjuvant Use of Midodrine to Intravenous Vasopressors: A Systematic Review and Meta-Analysis |
| title_short | Impact of Adjuvant Use of Midodrine to Intravenous Vasopressors: A Systematic Review and Meta-Analysis |
| title_sort | impact of adjuvant use of midodrine to intravenous vasopressors a systematic review and meta analysis |
| url | http://dx.doi.org/10.1155/2021/5588483 |
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