Optimal Vasopressin Initiation in Septic Shock: The OVISS Reinforcement Learning Study.

ABSTRACT:

Importance

Norepinephrine is the first-line vasopressor for patients with septic shock. When and whether a second agent, such as vasopressin, should be added is unknown.

Objective

To derive and validate a reinforcement learning model to determine the optimal initiation rule for vasopressin in adult, critically ill patients receiving norepinephrine for septic shock.

Design, setting, and participants

Reinforcement learning was used to generate the optimal rule for vasopressin initiation to improve short-term and hospital outcomes, using electronic health record data from 3608 patients who met the Sepsis-3 shock criteria at 5 California hospitals from 2012 to 2023. The rule was evaluated in 628 patients from the California dataset and 3 external datasets comprising 10 21

SUBMITTER: Kalimouttou A 

PROVIDER: S-EPMC11920879 | biostudies-literature | 2025 May

REPOSITORIES: biostudies-literature