Document Detail

Vasopressin deficiency and vasodilatory state in end-stage liver disease.
MedLine Citation:
PMID:  21126886     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Relative vasopressin deficiency, a contributor to vasodilatory septic shock, also may be a cause of the vasodilatory state in liver disease. This study assessed endogenous vasopressin levels in patients with liver disease and their hemodynamic response to exogenous vasopressin.
DESIGN: A prospective, observational study.
SETTING: A single-center, tertiary hospital.
PARTICIPANTS: Human subjects undergoing liver transplantation or major surgery.
INTERVENTIONS: Vasopressin levels were measured in 28 patients with liver disease undergoing liver transplantation and 7 control patients with normal liver function. Additionally, intravenous vasopressin was administered to 20 liver transplant recipients, and the hemodynamic response was observed.
MEASUREMENTS AND MAIN RESULTS: Patients with liver disease had significantly lower baseline vasopressin levels than controls (19.3 ± 27.1 pg/mL v 50.9 ± 36.7 pg/mL, p = 0.015). Patients with low vasopressin levels (≤20 pg/mL) were more likely to have lower baseline mean blood pressure (≤80 mmHg) than patients with high vasopressin levels (11/16 v 0/4, p = 0.013). Systemic vascular resistance increased by 33% 3 minutes after intravenous vasopressin. Thirteen of 16 patients with low vasopressin levels compared with 1 of 4 patients with high vasopressin levels responded to exogenous vasopressin, with an increase of mean blood pressure by more than 20% (p = 0.028).
CONCLUSIONS: Patients with liver disease have lower vasopressin levels than controls and respond with a brisk vasoconstrictor response to exogenous vasopressin. Therefore, relative endogenous vasopressin deficiency may contribute to vasodilatory shock in liver disease similar to what has been observed in septic shock.
Gebhard Wagener; Galina Kovalevskaya; Moury Minhaz; Fallon Mattis; Jean C Emond; Donald W Landry
Related Documents :
21117196 - Six-minute walk distance predicts mortality in liver transplant candidates.
23522346 - Comparing the diagnosis of laryngopharyngeal reflux between the reflux symptom index, c...
2772856 - Prescription of oxygen concentrators: adherence to published guidelines.
16191136 - Patient contribution to the medical dialogue and perceived patient-centeredness. an obs...
6807266 - Vitreoretinal degeneration in spondyloepiphyseal dysplasia congenita.
24652616 - Mri guided iron assessment and oral chelator use improve iron status in thalassemia maj...
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-12-03
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  25     ISSN:  1532-8422     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-09-13     Completed Date:  2012-03-07     Revised Date:  2014-09-24    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  665-70     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
End Stage Liver Disease / blood,  physiopathology*
Liver Transplantation
Middle Aged
Prospective Studies
Shock, Septic / blood
Vascular Resistance
Vasopressins / blood,  deficiency*,  physiology
Grant Support
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Validity and inter-day reliability of a free-oscillation test to measure knee extensor and knee flex...
Next Document:  Danish study of a modified Atkins diet for medically intractable epilepsy in children: can we achiev...