The University of Toledo Translation Journal of Medical Sciences 
Internal Medicine Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e1 

Utility of Midodrine During the Recovery Phase of Shock: 
A Systematic Review and Meta-Analysis 
W. Khokher, MD1*, S. Iftikhar, MD1, A. Beran, MD1, C. Burmeister, MD1, S.
Malhas, MD1, S. Malik, MD1, O. Srour, MD1, A. Abrahamian, MD1, A. Alharbi,
MD1, N. Kesireddy, MD1, T. Saif, MD1, R. Assaly, MD2

1Division of Internal Medicine, Department of Medicine, The University of Toledo, 
Toledo, OH 43614 
2Division of Pulmonary and Critical Care Medicine, Department of Medicine, The 
University of Toledo, Toledo, OH 43614 

*Corresponding author: Waleed.Khokher@utoledo.edu

Published: 05 May 2023 

Introduction: The use of midodrine is becoming common in the intensive care unit (ICU), but the data 
remains unclear. Therefore, we performed a meta-analysis of available randomized controlled trials 
(RCTs) to evaluate the efficacy and safety of using midodrine in conjunction with intravenous 
vasopressors (IVVs).    

Methods: Comprehensive literature search of PubMed, Embase, Web of Science, and Cochrane Library 
databases from inception through April 07, 2022, for all published studies investigating the use of 
midodrine in the ICU in patients requiring IVV. Our primary outcome was the total duration of IVVs 
use. Secondary outcomes were IVV weaning time, ICU LOS, hospital LOS, and adverse events.    

Results: 5 RCTs involving 346 patients (175 patients received midodrine plus IVVs and 171 received 
standard care with only IVVs or IVVs plus placebo) were included. There was no significant difference 
in total duration of IVV use, IVV weaning time, ICU LOS, hospital LOS, or adverse events between the 
two groups.   

Conclusion: The addition of midodrine was not associated with a shorter duration of IVV use or quicker 
weaning of IVVs. Midodrine use also did not significantly reduce ICU and hospital LOS. 

https://dx.doi.org/10.46570/utjms.vol11-2023-707 

https://dx.doi.org/10.46570/utjms.vol11-2023-707
mailto:Waleed.Khokher@utoledo.edu