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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.

Midodrine use in intensive care unit patients recovering from septic shock