Low plasma vasopressin/norepinephrine ratio predicts septic shock

Lin, I-Yin; Ma, Hon-Ping; Lin, Aming Chor-Ming; Chong, Chee-Fah; Lin, Chin‐Jung; Wang, Tzong-Luen

doi:10.1016/j.ajem.2005.02.055

Cited by 40 publications

(24 citation statements)

References 28 publications

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“…Landry et al [6,7] first discovered that vasopressin levels are inappropriately low in septic shock. Others found [9] in patients in emergency rooms that vasopressin levels were lower in those who went on to septic shock (3.6 pg/ml) compared to those who had sepsis (10.6 pg/ ml) and severe sepsis (21.8 pg/ml). Vasopressin levels remain extremely low for up to 7 days after onset of septic shock [10] .…”

Section: Circulating Vasopressin Concentrationsmentioning

confidence: 98%

Vasopressin and Its Immune Effects in Septic Shock

Russell

Walley²

2010

J Innate Immun

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clinical studies of vasopressin infusion in septic shock have shown that vasopressin infusion increases blood pressure, decreases requirements for norepinephrine and improves renal function. However, vasopressin could decrease coronary, cerebral and mesenteric perfusion. A multicenter trial of vasopressin versus norepinephrine in septic shock found no overall difference in mortality. Vasopressin may decrease mortality in patients with less severe septic shock. Vasopressin plus corticosteroid treatment may decrease mortality compared to corticosteroids plus norepinephrine. Potential mechanisms are that vasopressin plus corticosteroids beneficially alter immunity in septic shock.

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Section: Circulating Vasopressin Concentrationsmentioning

confidence: 98%

Vasopressin and Its Immune Effects in Septic Shock

Russell

Walley²

2010

J Innate Immun

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“…Vasopressin, an endogenously released peptide hormone, is recommended for patients with severe septic shock as an adjunct to catecholamines, since a relative vasopressin deficiency is apparent in patients with sepsis (57). Evidence for the use of vasopressin in septic shock has been described in two small randomized trials that showed improvement in hemodynamic parameters and renal function in patients treated with vasopressin (58,59).…”

Section: Septic Shockmentioning

confidence: 99%

Review and update on inotropes and vasopressors: Evidence-based use in cardiovascular diseases

Kalçık¹,

Gürsoy²

2015

Curr Res Cardiol

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Patients in the intensive care unit frequently develop low-output syndromes due to cardiac dysfunction, myocardial injury and activation of inflammatory cascades. Pharmacological agents, including vasodilators, inotropes and vasopressors, are frequently used in the critical care setting for the management of unstable cardiac patients. These medications are used to elicit varying effects on vascular resistance, myocardial contractility and heart rate to achieve desired hemodynamic and clinical end points. Conventional inotropic agents appear to be useful in restoring hemodynamic parameters and improving peripheral organ perfusion, but they can increase short-term and long-term mortality in these patients. Novel inotropes may be promising in the management of cardiogenic shock patients without serious adverse effects. The present review summarizes the current knowledge about the pathophysiology and evidence-based use of conventional and novel inotropic agents in various clinical scenarios associated with cardiovascular diseases.

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“…As circulating level of endogenous vasopressin is low in septic shock [3,4], clinical guidelines have suggested exogenous vasopressin replacement as part of the therapies against severe sepsis [5]. On top of that, exogenous vasopressin replacement has been shown to remedy inflammation-induced damages, as vasopressin could decrease sepsis-induced pulmonary inflammation [6] and preserve renal and mesenteric blood flow in septic animals [7,8].…”

Section: Introductionmentioning

confidence: 99%