{
  "abstract": "BACKGROUNDS: Women with cardiogenic shock (CS) under VA-ECMO face excess mortality, yet the pharmacological basis of this disparity remains poorly understood. Arginine vasopressin (AVP) is increasingly used as a non-adrenergic vasopressor in this setting, but whether sex modifies the hemodynamic response to AVP is unknown. METHODS: In this multicenter retrospective cohort of VA-ECMO-supported CS patients, we assessed whether sex was independently associated with successful vasopressor de-escalation at 48 hours (norepinephrine equivalent dose [NEE] <0.25 µg/kg/min) after AVP initiation. Multivariable logistic regression and linear mixed-effects models were used to evaluate sex differences in treatment response and NEE trajectories over time. RESULTS: Among 193 eligible patients, 32% of women achieved successful de-escalation versus 49% of men (p = 0.023). Male sex was independently associated with treatment success (aOR 2.08, 95% CI 1.07-4.15, p = 0.033). A significant sex-by-time interaction was observed in NEE trajectories (p = 0.041), with divergence emerging at 48 hours (NEE 0.24 vs. 0.01 µg/kg/min, p = 0.008). The excess failure risk was confined to postmenopausal women aged ≥55 years (aOR 2.75, 95% CI 1.32-5.93, p = 0.008). CONCLUSION: Female sex, particularly in a postmenopausal context, was independently associated with impaired vasopressor de-escalation following AVP in CS on VA-ECMO. These hypothesis-generating findings suggest that hormonal status may modulate vascular responsiveness to AVP and support the need for prospective studies incorporating hormonal profiling.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "name": "Christophe Beyls"
    },
    {
      "name": "Louis Gibert"
    },
    {
      "name": "Anna Urbanc"
    },
    {
      "name": "Rebiha Boughanemed"
    },
    {
      "name": "Bélaïd Bouhemad"
    },
    {
      "name": "Yazine Mahjoub"
    },
    {
      "name": "Emmanuel Besnier"
    },
    {
      "name": "Osama Abou-Arab"
    },
    {
      "name": "Pierre-Grégoire Guinot"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1wa4f6hkk038p.bib",
  "cited_by": 0,
  "doi": "10.1016/j.accpm.2026.101949",
  "fulltext_url": null,
  "id": "1wa4f6hkk038p",
  "issns": [
    "2352-5568"
  ],
  "landing_url": "https://u-picardie.hal.science/hal-05801546v1",
  "language": "en",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "hal",
      "1.sdv.mhep"
    ],
    [
      "hal",
      "2.sdv.mhep.csc"
    ],
    [
      "openalex",
      "2204|Mechanical Circulatory Support Devices"
    ]
  ],
  "openalex": "W7221694521",
  "pdf_url": "https://www.sciencedirect.com/science/article/pii/S2352556826002079/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-15",
  "publisher": "Elsevier Masson",
  "ris": "https://research.draconitic.com/paper/1wa4f6hkk038p.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:57Z",
      "native_id": "hal-05801546",
      "source": "hal",
      "url": "https://u-picardie.hal.science/hal-05801546v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "hal:0.sdv",
      "subfield": "general"
    },
    {
      "field": "medicine",
      "origin": "hal:2.sdv.mhep.csc",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Sex Differences in Vasopressor De-escalation With Arginine Vasopressin in Mixed Cardiogenic-Vasodilatory Shock Under VA-ECMO",
  "title_text": "Sex Differences in Vasopressor De-escalation With Arginine Vasopressin in Mixed Cardiogenic-Vasodilatory Shock Under VA-ECMO",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:57Z",
  "url": "https://research.draconitic.com/paper/1wa4f6hkk038p",
  "venue": "Anaesthesia Critical Care & Pain Medicine",
  "versions": []
}