Document Detail


Vasopressin in vasodilatory and septic shock.
MedLine Citation:
PMID:  17599007     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: The aim of this article is to review mechanisms of action of vasopressin and clinical studies of vasopressin in septic shock. RECENT FINDINGS: Arginine vasopressin is an important stress hormone that has both vasoactive and antidiuretic properties. The vasoactive properties of vasopressin have been more applicable clinically because of the discovery by Landry and colleagues that there is a deficiency of vasopressin in septic shock and that infusion of relatively low doses of vasopressin improves responsiveness to infused catecholamines (such as norepinephrine). There are at least 16 clinical studies of infusion of vasopressin in patients who have septic shock. The majority of studies found that vasopressin infusion increased blood pressure and urine output, and decreased the dose requirement of norepinephrine. Several studies showed that vasopressin infusion increased urine output. Both vasopressin and norepinephrine have important adverse effects including decreased cardiac output, decreased heart rate, arrhythmias, myocardial ischemia, mesenteric ischemia, and digital ischemia. SUMMARY: It is still unclear whether there is net benefit from low dose vasopressin infusion in patients who have septic shock. There may be certain patients who benefit but there are few studies of a prolonged vasopressin infusion to determine which patients benefit.
Authors:
James A Russell
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in critical care     Volume:  13     ISSN:  1070-5295     ISO Abbreviation:  Curr Opin Crit Care     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-06-29     Completed Date:  2007-10-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9504454     Medline TA:  Curr Opin Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  383-91     Citation Subset:  IM    
Affiliation:
Division of Critical Care Medicine, University Of British Columbia, Vancouver. British Columbia, Canada. jrussell@mrl.ubc.ca
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MeSH Terms
Descriptor/Qualifier:
Humans
Norepinephrine
Receptors, Vasopressin
Shock, Septic / drug therapy*,  physiopathology
Vasodilation / drug effects*
Vasopressins / administration & dosage,  pharmacokinetics*,  therapeutic use
Chemical
Reg. No./Substance:
0/Receptors, Vasopressin; 11000-17-2/Vasopressins; 51-41-2/Norepinephrine

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


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