Midodrine use in intensive care unit patients recovering from septic shock

  • Bethannie D Dziuk
  • Kenneth Iwuji
Keywords: midodrine, vasopressor, septic shock, alpha (1)-agonist, refractory hypotension, intensive care unit


Background: With the rising cost of ICU care and concerns about vasopressor associated complications, clinicians need oral medications that can hasten recovery from septic shock in patients requiring low dose IV vasopressors.

Methods: We retrieved all the available studies published on PubMed and Embase (until September 2018) that reported the use of midodrine in septic shock.

Results: Levine et al reported a decrease in the intravenous vasopressor infusion rate from -0.62 ± 1.40 mcg/min per hour before midodrine to -2.20 ± 2.45 mcg/min per hour after the first four doses of midodrine (P = 0.012). Whitson et al reported a two-day decrease in mean ICU length of stay when midodrine was used with IV vasopressors (P = 0.017).

Conclusions: Midodrine may have the potential to hasten vasopressor weaning in patients recovering from septic shock, but there are limited published data available to support its use in these patients.


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Anstey MH, Wibrow B, Thevathasan T, et al. Midodrine as adjunctive support for treatment of refractory hypotension in the intensive care unit: a multicenter randomized, placebo controlled trial (the MIDAS trial). BMC Anesthesiol 2017 Mar 21;17(1):47.

How to Cite
Dziuk, B. D., & Iwuji, K. (2018). Midodrine use in intensive care unit patients recovering from septic shock. The Southwest Respiratory and Critical Care Chronicles, 6(26), 26-29. https://doi.org/10.12746/swrccc.v6i26.509