Correspondence  |   January 2018
In Reply
Author Notes
  • University of British Columbia and St. Paul’s Hospital, Vancouver, British Columbia, Canada. jim.russell@hli.ubc.ca
  • (Accepted for publication September 27, 2017.)
    (Accepted for publication September 27, 2017.)×
Article Information
Correspondence
Correspondence   |   January 2018
In Reply
Anesthesiology 1 2018, Vol.128, 230-231. doi:10.1097/ALN.0000000000001957
Anesthesiology 1 2018, Vol.128, 230-231. doi:10.1097/ALN.0000000000001957
Drs. Fan and Faraday write with concerns about the Vasopressin and Cardiac Surgery Trial1  and my editorial2 ; I agree with some, but not all, of their points. My first point of agreement is the criticism that clinical treatment was not protocolized; however, in most randomized controlled trials, nonrandomized care is most often not protocolized for simple logistical reasons. The point is that nonprotocolized care was used in both masked arms of the Vasopressin and Cardiac Surgery Trial. Greater use of dobutamine in the norepinephrine group in the Vasopressin and Cardiac Surgery Trial could have been because vasopressin had less negative inotropic effects than norepinephrine, as vasopressin has some vasodilation action due to release of nitric oxide.3,4 
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