Document Detail


Vasopressin in sepsis and septic shock.
MedLine Citation:
PMID:  20935620     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Arginine vasopressin (AVP) and its synthetic, long-acting analog terlipressin (TP) are potent alternative vasoconstrictors in the treatment of septic patients with catecholamine-refractive vasodilatatory shock. The results from one large randomized clinical trial suggest that AVP plus norepinephrine (NE) infusion is as safe and effective as treatment with NE alone in patients with septic shock. Because the desired effects of vasopressin analogs are basically related to their vasopressinergic effects via the V1a receptor, more selective V1 agonists, such as TP, may be more potent in reversing sepsis-related arterial hypotension. In this regard, recent evidence from small-scale studies suggests that continuous low-dose infusion rather than intermittent bolus injection of TP is associated with fewer side effects, such as depression of cardiac output and rebound arterial hypotension. However, because clinical data on the administration of TP in patients with sepsis are limited, it should not currently be used beyond the scope of controlled trials. The optimal time point for the initiation of therapy with vasopressin analogs has yet to be determined. While AVP and TP are commonly used as last-resort therapies in severe septic shock, some evidence supports the initiation of treatment in a less severe state of the disease.
Authors:
T G Kampmeier; S Rehberg; M Westphal; M Lange
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Minerva anestesiologica     Volume:  76     ISSN:  1827-1596     ISO Abbreviation:  Minerva Anestesiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-11     Completed Date:  2011-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375272     Medline TA:  Minerva Anestesiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  844-50     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Intensive Care, University of Muenster, Muenster, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / adverse effects,  pharmacology,  therapeutic use
Animals
Arginine Vasopressin / administration & dosage,  adverse effects,  chemistry,  pharmacology,  therapeutic use*
Catecholamines / adverse effects,  pharmacology,  therapeutic use
Drug Administration Routes
Drug Administration Schedule
Drug Evaluation, Preclinical
Drug Interactions
Drug Therapy, Combination
Humans
Hypotension / drug therapy*,  etiology
Ischemia / chemically induced
Lypressin / administration & dosage,  adverse effects,  analogs & derivatives*,  chemistry,  pharmacology,  therapeutic use
Molecular Structure
Multicenter Studies as Topic
Randomized Controlled Trials as Topic
Receptors, Vasopressin / agonists,  physiology
Sepsis / complications,  physiopathology*
Shock, Septic / complications,  physiopathology
Vasoconstriction / drug effects
Vasoconstrictor Agents / administration & dosage,  adverse effects,  therapeutic use*
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Catecholamines; 0/Receptors, Vasopressin; 0/Vasoconstrictor Agents; 113-79-1/Arginine Vasopressin; 14636-12-5/terlipressin; 50-57-7/Lypressin

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


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