| ||||||||||||||
|
|
|||||||||||||

*Division of General and Surgical Intensive Care Medicine, Department of Anesthesia and Critical Care Medicine; and
Department of Medical Biostatistics, The Leopold Franzens University of Innsbruck, Innsbruck, Austria
Address correspondence and reprint requests to Walter R. Hasibeder, MD, Division of General and Surgical Intensive Care Medicine, Department of Anesthesia and Critical Care Medicine, The Leopold Franzens University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. Address e-mail to Walter.Hasibeder@ uibk.ac.at.
We retrospectively investigated the effects of continuous arginine vasopressin (AVP) infusion on systemic hemodynamics, acid/base status, and laboratory variables in patients (mean age [mean ± SD]= 66.3 ± 10.1 yr) with catecholamine-resistant septic (n = 35) or postcardiotomy shock (n = 25). Hemodynamic and acid/base data were obtained before; 30 min after; and 1, 4, 12, 24, 48, and 72 h after the start of AVP infusion. Laboratory examinations were recorded before and 24, 48, and 72 h after the start of AVP infusion. For statistical analysis, a mixed-effects model was used. The overall intensive care unit mortality was 66.7%. AVP administration caused a significant increase in mean arterial pressure (+29%) and systemic vascular resistance (+56%), accompanied by a significant decrease in heart rate (-24%) and mean pulmonary arterial pressure (-11%) without any change in stroke volume index. Norepinephrine requirements could be reduced by 72% within 72 h. During AVP infusion, a significant increase in liver enzymes and total bilirubin concentration and a significant decrease in platelet count occurred. Arginine vasopressin was effective in reversing systemic hypotension. However, adverse effects on gastrointestinal perfusion and coagulation cannot be excluded.
Implications: In this retrospective analysis, the influence of a continuous infusion of anendogenous hormone (arginine vasopressin) on systemic hemodynamics andlaboratory variables was assessed in patients with vasodilatory shockunresponsive to conventional therapy. Arginine vasopressin was effective inreversing systemic hypotension. However, adverse effects on gastrointestinalperfusion and coagulation cannot beexcluded.
This article has been cited by other articles:
![]() |
T. Kawano, K. Tanaka, H. Nazari, S. Oshita, A. Takahashi, and Y. Nakaya The Effects of Extracellular pH on Vasopressin Inhibition of ATP-Sensitive K+ Channels in Vascular Smooth Muscle Cells Anesth. Analg., December 1, 2007; 105(6): 1714 - 1719. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. C. Price, P. Forrest, V. Sodhi, D. L. Adamson, C. Nelson-Piercy, M. Lucey, and L. S. Howard Use of vasopressin after Caesarean section in idiopathic pulmonary arterial hypertension Br. J. Anaesth., October 1, 2007; 99(4): 552 - 555. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Egi, R. Bellomo, C. Langenberg, M. Haase, A. Haase, L. Doolan, G. Matalanis, S. Seevenayagam, and B. Buxton Selecting a Vasopressor Drug for Vasoplegic Shock After Adult Cardiac Surgery: A Systematic Literature Review Ann. Thorac. Surg., February 1, 2007; 83(2): 715 - 723. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. Farand, M. Hamel, F. Lauzier, G. E. Plante, and O. Lesur Review article: Organ perfusion/permeability-related effects of norepinephrine and vasopressin in sepsis: [Expose de synthese : Les effets relies a la perfusion et a la permeabilite organique de la norepinephrine et de la vasopressine durant le "sepsis"]. Can J Anesth, September 1, 2006; 53(9): 934 - 946. [Abstract] [Full Text] [PDF] |
||||
![]() |
Y. Jeon, J. H. Ryu, Y. J. Lim, C. S. Kim, J.-H. Bahk, S. Z. Yoon, and J. Y. Choi Comparative hemodynamic effects of vasopressin and norepinephrine after milrinone-induced hypotension in off-pump coronary artery bypass surgical patients. Eur. J. Cardiothorac. Surg., June 1, 2006; 29(6): 952 - 956. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. M. Szumita, C. M. Enfanto, B. Greenwood, and M. E. Wechsler Vasopressin for vasopressor-dependent septic shock Am. J. Health Syst. Pharm., September 15, 2005; 62(18): 1931 - 1936. [Full Text] [PDF] |
||||
![]() |
K. H. Stadlbauer, V. Wenzel, A. C. Krismer, W. G. Voelckel, and K. H. Lindner Vasopressin During Uncontrolled Hemorrhagic Shock: Less Bleeding Below the Diaphragm, More Perfusion Above Anesth. Analg., September 1, 2005; 101(3): 830 - 832. [Full Text] [PDF] |
||||
![]() |
H. Knotzer, W. Pajk, S. Maier, R. Ladurner, A. Kleinsasser, V. Wenzel, M. W. Dunser, H. Ulmer, and W. R. Hasibeder Arginine vasopressin reduces intestinal oxygen supply and mucosal tissue oxygen tension Am J Physiol Heart Circ Physiol, July 1, 2005; 289(1): H168 - H173. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Bennett, R. P. Mahajan, J. E. March, P. A. Kemp, and S. M. Gardiner Regional and temporal changes in cardiovascular responses to norepinephrine and vasopressin during continuous infusion of lipopolysaccharide in conscious rats Br. J. Anaesth., September 1, 2004; 93(3): 400 - 407. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. B. Braun, C. A. Palin, and C. W. Hogue Vasopressin During Spinal Anesthesia in a Patient with Primary Pulmonary Hypertension Treated with Intravenous Epoprostenol Anesth. Analg., July 1, 2004; 99(1): 36 - 37. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. W. Dunser, D. R. Fries, W. Schobersberger, H. Ulmer, V. Wenzel, B. Friesenecker, W. R. Hasibeder, and A. J. Mayr Does Arginine Vasopressin Influence the Coagulation System in Advanced Vasodilatory Shock with Severe Multiorgan Dysfunction Syndrome? Anesth. Analg., July 1, 2004; 99(1): 201 - 206. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. D Obritsch, R. Jung, D. N Fish, and R. MacLaren Effects of Continuous Vasopressin Infusion in Patients with Septic Shock Ann. Pharmacother., July 1, 2004; 38(7): 1117 - 1122. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. R. Williams, A. Y. Denault, M. Pellerin, and R. Martineau Vasopressin for treatment of shock following aprotinin administration: [Traitement a la vasopressine pour un choc suivant l'administration d'aprotinine] Can J Anesth, February 1, 2004; 51(2): 169 - 172. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. M. P. van Haren, F. W. Rozendaal, and J. G. van der Hoeven The Effect of Vasopressin on Gastric Perfusion in Catecholamine-Dependent Patients in Septic Shock Chest, December 1, 2003; 124(6): 2256 - 2260. [Abstract] [Full Text] [PDF] |
||||
![]() |
Q. Sun, G. Dimopoulos, D. N. Nguyen, Z. Tu, N. Nagy, A. D. Hoang, P. Rogiers, D. De Backer, and J.-L. Vincent Low-Dose Vasopressin in the Treatment of Septic Shock in Sheep Am. J. Respir. Crit. Care Med., August 15, 2003; 168(4): 481 - 486. [Abstract] [Full Text] [PDF] |
||||
![]() |
C.-C. Yeh, C.-T. Wu, C.-H. Lu, C.-P. Yang, and C.-S. Wong Early Use of Small-Dose Vasopressin for Unstable Hemodynamics in an Acute Brain Injury Patient Refractory to Catecholamine Treatment: A Case Report Anesth. Analg., August 1, 2003; 97(2): 577 - 579. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. W. Dunser, A. J. Mayr, H. Ulmer, H. Knotzer, G. Sumann, W. Pajk, B. Friesenecker, and W. R. Hasibeder Arginine Vasopressin in Advanced Vasodilatory Shock: A Prospective, Randomized, Controlled Study Circulation, May 13, 2003; 107(18): 2313 - 2319. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. L. Bratton Vasopressin in Refractory Hypotension AAP Grand Rounds, August 1, 2002; 8(2): 20 - 20. [Full Text] [PDF] |
||||
![]() |
K. Meersschaert, L. Brun, M. Gourdin, S. Mouren, M. Bertrand, B. Riou, and P. Coriat Terlipressin-Ephedrine Versus Ephedrine to Treat Hypotension at the Induction of Anesthesia in Patients Chronically Treated with Angiotensin Converting-Enzyme Inhibitors: A Prospective, Randomized, Double-Blinded, Crossover Study Anesth. Analg., April 1, 2002; 94(4): 835 - 840. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Chamorro, J. A. Silva, M. A. Romera, J. Marquez, C. Pardo, W. R. Hasibeder, M. W. Dunser, and A. J. Mayr Vasopressin Effect on Pulmonary Arterial Pressure Response Anesth. Analg., February 1, 2002; 94(2): 479 - 479. [Full Text] [PDF] |
||||
![]() |
K. A. Thielmeier, J. R. Pank, R. D. Dowling, and L. A. Gray JR Anesthetic and Perioperative Considerations in Patients Undergoing Placement of Totally Implantable Replacement Hearts Seminars in Cardiothoracic and Vascular Anesthesia, November 1, 2001; 5(4): 335 - 344. [Abstract] [PDF] |
||||
|