Impact of Low‐dose Vasopressin on Trauma Outcome: Prospective Randomized Study

Abstract

This is the first trial to investigate the impact of vasopressin administration in trauma patients. Infusion of low-dose vasopressin maintained elevated serum vasopressin levels and decreased fluid requirements after injury.

Characterizing vasopressin and other vasoactive mediators released during resuscitation of trauma patients

“…Following severe injury, patients may ultimately be shown to benefit from administration of a low dose of vasopressin and/or epinephrine to avoid the development of refractory shock states. 36,37 AUTHORSHIP S.M.C. contributed to the literature search, study design, data analysis, data interpretation, writing, and figures.…”

Vasopressor and Inotrope Use in Canadian Emergency Departments: Evidence Based Consensus Guidelines

“…Vasopressin has also been studied in a chart review and a weak RCT showing some benefit. 24,30 However, Collier et al 25 showed that the use of vasopressin was associated with increased mortality in their retrospective cohort analysis. A multi-centre RCT is currently in progress to assess the rate of admission to hospital, fluid requirements, hemodynamic variables, and rate of discharge in a population of traumatic refractory hemorrhagic shock patients treated with vasopressin or placebo.…”

“…Rationale: The use of any vasopressor in the treatment of hemorrhagic shock in humans has been evaluated thus far in scattered case reports, four medical record reviews, one prospective cohort study, and one RCT. [24][25][26][27][28][29][30][31] Two negative studies 25,31 have shown an association with increased mortality in patients who received vasopressors, but the remaining studies show positive outcomes with respect to survival. Most studies involved the use of vasopressin 24,25,27,29,30 (see next section).…”

Effects of Intraosseous Erythropoietin during Hemorrhagic Shock in Swine

“…In models of HS, vasopressin was comparably superior to fluid administration or epinephrine [42], [43] and has been proposed as the “preferred” vasopressor agent for hemodynamic stabilization during HS [41]. In a small clinical study in civilians suffering traumatic injury with hypotension, vasopressin infusion reduced the need of resuscitation fluids [44]. Clinicaltrials.gov lists two studies examining the effects of vasopressin in civilians with HS; the AVERT Shock study by Sims, C and the VITRIS study by Wenzel, V. [45].…”