Low-Dose Vasopressin in the Treatment of Vasodilatory Septic Shock

Malay, Mary Beth; Ashton, Robert C.; Landry, Donald W.; Townsend, Ricard N.

doi:10.1097/00005373-199910000-00014

Cited by 334 publications

(176 citation statements)

References 12 publications

Supporting

Mentioning

161

Contrasting

Unclassified

Order By: Relevance

“…The results of the present study are in agreement with other studies [3,4,[9][10][11], on the effectiveness of lowdose vasopressin infusion in patients with vasodilatory septic shock. The present study shows that vasopressin infusion spared use of conventional catecholamines.…”

Section: Discussionsupporting

confidence: 93%

Effects of Low Dose Vasopressin in Catecholamine Resistant Septic Shock

Sharma

Setlur

Prabhakaran³

et al. 2008

Medical Journal Armed Forces India

View full text Add to dashboard Cite

Background: Septic shock commonly leads to death in critically ill patients. Severe hypotension resistant to conventional catecholamine leads to multiorgan failure. We studied the effectiveness of low dose vasopressin in resistant septic shock. Methods: Thirty critically ill patients with catecholamine resistant hypotension were included in the study. After adequate fluid resuscitation, infusion of norepinephrine and dobutamine was started. If the patient remained hypotensive, vasopressin was infused at a fixed rate of 0.04 unit/minute for 24 hours. Haemodynamic parameters and mortality rates were recorded. Result: There was a significant improvement in systolic and mean arterial pressure within four hours of starting vasopressin. This improvement continued throughout the 24-hour period. In addition, it was possible to withdraw dopamine in all the patients and significantly reduce infusion rates of dobutamine and norepinephrine. No significant complication was noted. Conclusion: Low dose vasopressin at the rate of 0.04 unit/minute is an effective vasopressor in adult patients with catecholamine resistant septic shock. MJAFI 2008; 64 : 304-307

show abstract

Section: Discussionsupporting

confidence: 93%

Effects of Low Dose Vasopressin in Catecholamine Resistant Septic Shock

Sharma

Setlur

Prabhakaran³

et al. 2008

Medical Journal Armed Forces India

View full text Add to dashboard Cite

show abstract

“…Nonetheless, mortality data remains limited. While two small randomized controlled trials (RCTs) have previously examined the role of vasopressin in septic shock, 5,6 neither study was adequately powered to evaluate mortality, organ dysfunction, or safety. 2 As such, the ''Vasopressin and Septic Shock Trial'' (VASST) by Russell et al was eagerly anticipated.…”

Section: Study Relevancementioning

confidence: 99%

Vasopressin in septic shock: pressing questions remain

Keyes

Brindley

2008

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Article appraisedRussell JA, Walley KR, Singer J, et al.; VASST Investigators. Vasopressin versus norepinephrine infusion in patients with septic shock. N Engl J Med 2008; 258: 877-87. Structured AbstractBackground: The use of low-dose vasopressin as an adjunctive vasopressor in septic shock is common, but its effect on mortality is unknown.Objective: To determine whether a low-dose vasopressin infusion reduces mortality in septic shock when added to an infusion of norepinephrine.Design and Setting: Multicentre, multiple-blinded, randomized controlled trial conducted in three countries from July, 2001 to April, 2006.Patients: Inclusion criteria were patients C17 years of age with septic shock requiring C5 ug min -1 of norepinephrine (or equivalent) for C6 h, or requiring C15 ug min -1 of norepinephrine (or equivalent) for C3 h, despite having received C500 ml of normal saline. Study enrolment was only permitted within 24 h of meeting inclusion criteria. Exclusion criteria included previous use of vasopressin, acute myocardial infarction, New York Heart Association class III or IV congestive heart failure, acute mesenteric ischemia, severe traumatic brain injury, hyponatremia \130 mmol l -1 , Raynaud's phenomenon, systemic sclerosis, vasospastic diathesis, pregnancy, an irreversible condition with an estimated six-month mortality C50%,

show abstract

“…[27][28][29][30] The catecholamine sparing effects of vasopressin have also been shown in several case series of patients in septic shock. [31][32][33] Consequently, vasopressin has been recommended as initial therapy for hemodynamic support and the treatment of DI in the cadaveric donor by the American College of Cardiology. 34 Expert consensus recommends that every cadaveric donor should undergo central venous pressure (CVP) monitoring.…”

Section: Temporal Considerationsmentioning

confidence: 99%

Medical management to optimize donor organ potential: review of the literature

Kutsogiannis

Pagliarello

Doig

et al. 2006

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose: Over the past two decades, the demand for donor organs continues to outpace the number of organs available for transplantation. Parallel with this has been a change in the demographics of organ donors with an increase in older donors and donors with marginal organs as a proportion of the total organ donor pool. Consequently, efforts have been made to improve the medical care delivered to potential organ donors to improve the conversion rate and graft survival of available organs. The purpose of this literature review is to provide updated recommendations for the contemporary management of organ donors after the neurological determination of death in order to maximize the probability of recipient graft survival. Sources:A comprehensive review of the literature obtained through searches of MEDLINE/PubMed, and personal reference files.Principal findings: Contemporary management of the organ donor after neurological determination of death includes therapies to prevent the detrimental effects of the autonomic storm, the use of invasive hemodynamic monitoring and aggressive respiratory therapy including therapeutic bronchoscopy in marginal heart and lung donors, and the use of hormonal therapy including vasopressin, corticosteroids, triiodothyronine or thyroxine, and insulin for the pituitary failure and inflammation seen in brain dead organ donors. The importance of normalizing donor physiology to optimize all available organs is stressed. Conclusion:Aggressive hemodynamic and respiratory management of solid organ donors, coupled with the use of hormonal therapy improves the rate of conversion and graft survival in solid organ recipients. Objectif

show abstract

Low-Dose Vasopressin in the Treatment of Vasodilatory Septic Shock

Abstract: A VP infusion improved arterial pressure and permitted the withdrawal of catecholamine vasopressors. VP is a useful agent in the treatment of refractory septic shock.

Cited by 334 publications

References 12 publications

Effects of Low Dose Vasopressin in Catecholamine Resistant Septic Shock

Effects of Low Dose Vasopressin in Catecholamine Resistant Septic Shock

Vasopressin in septic shock: pressing questions remain

Medical management to optimize donor organ potential: review of the literature

Contact Info

Product

Resources

About