Cleveland Clinic Journal of MedicineShould Midodrine Be Used as an Intravenous Vasopressor-sparing Agent in Septic Shock?

This “1-Minute Consult” from the Cleveland Clinic Journal of Medicine explores the potential use of midodrine as an alternative to intravenous vasopressors (IVPs) in treating septic shock. The authors, Simran Gupta, MD, Ayan Sen, MD, and Aman Verma, DO, present a detailed analysis of the current standard-of-care treatment for septic shock and the potential role of midodrine.

HCN Medical Memo
The findings of this article could have significant implications for healthcare professionals. Although midodrine shows promise in weaning down IVPs during the recovery phase of septic shock, it is not yet a proven alternative to avoid or delay IVP therapy or ICU admission. This information could impact their practice and patient care by informing their decisions on treatment strategies for septic shock.

Key Points

• The article presents a case of a 55-year-old male patient with septic shock.
• Midodrine is an oral alpha-1 adrenergic receptor agonist approved for symptomatic hypotension.
• Some research suggests that midodrine may be used to wean down IVPs in select patients during the recovery phase of septic shock.
• However, there are no robust data to suggest that midodrine can be used to avoid or delay IVP therapy or intensive care unit (ICU) admission in patients with septic shock.

According to a study by the CDC, each year at least 1.7 million adults in America develop sepsis and nearly 270,000 die as a result.

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