Document Detail

The use of vasopressin for treating vasodilatory shock and cardiopulmonary arrest.
MedLine Citation:
PMID:  19691565     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To discuss 3 potential mechanisms for loss of peripheral vasomotor tone during vasodilatory shock; review vasopressin physiology; review the available animal experimental and human clinical studies of vasopressin in vasodilatory shock and cardiopulmonary arrest; and make recommendations based on review of the data for the use of vasopressin in vasodilatory shock and cardiopulmonary arrest. DATA SOURCES: Human clinical studies, veterinary experimental studies, forum proceedings, book chapters, and American Heart Association guidelines. HUMAN AND VETERINARY DATA SYNTHESIS: Septic shock is the most common form of vasodilatory shock. The exogenous administration of vasopressin in animal models of fluid-resuscitated septic and hemorrhagic shock significantly increases mean arterial pressure and improves survival. The effect of vasopressin on return to spontaneous circulation, initial cardiac rhythm, and survival compared with epinephrine is mixed. Improved survival in human patients with ventricular fibrillation, pulseless ventricular tachycardia, and nonspecific cardiopulmonary arrest has been observed in 4 small studies of vasopressin versus epinephrine. Three large studies, though, did not find a significant difference between vasopressin and epinephrine in patients with cardiopulmonary arrest regardless of initial cardiac rhythm. No veterinary clinical trials have been performed using vasopressin in cardiopulmonary arrest. CONCLUSION: Vasopressin (0.01-0.04 U/min, IV) should be considered in small animal veterinary patients with vasodilatory shock that is unresponsive to fluid resuscitation and catecholamine (dobutamine, dopamine, and norepinephrine) administration. Vasopressin (0.2-0.8 U/kg, IV once) administration during cardiopulmonary resuscitation in small animal veterinary patients with pulseless electrical activity or ventricular asystole may be beneficial for myocardial and cerebral blood flow.
Richard D Scroggin; Jane Quandt
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)     Volume:  19     ISSN:  1476-4431     ISO Abbreviation:  J Vet Emerg Crit Care (San Antonio)     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-08-20     Completed Date:  2009-11-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101152804     Medline TA:  J Vet Emerg Crit Care (San Antonio)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  145-57     Citation Subset:  IM    
Veterinary Specialist of North Texas & Animal Cancer Center, 12101 Greenville Avenue, Suite 114 Dallas, TX 75243, USA.
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MeSH Terms
Animals, Domestic*
Heart Arrest / drug therapy,  veterinary*
Shock / drug therapy,  veterinary*
Vasoconstrictor Agents / therapeutic use*
Vasopressins / therapeutic use*
Reg. No./Substance:
0/Vasoconstrictor Agents; 11000-17-2/Vasopressins

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

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