Vasopressin in the treatment of vasodilatory shock in children

Abstract

Vasopressin deficiency may occur in catecholamine-resistant hypotension of pediatric patients due to various causes including central nervous system disturbance, drug induced hypotension and sepsis. Small doses of vasopressin administration seems to be very effective in such conditions by increasing blood pressure and urinary output.

Cardiovascular Drug Therapy for Human Newborn: Review of Pharmacodynamic Data

“…In fact in a group of children with septic shock AVP levels have been found elevated compared to patients without shock [98]. The course of AVP levels in newborns with shock remains to be investigated since low levels of AVP during shock regardless of the cause has been found to be associated with a better response to exogenous AVP/TP treatment [99].…”

Arginine-vasopressin in neonates with vasodilatory shock after cardiopulmonary bypass

“…Argininevasopressin (AVP) led to resolution of hypotension and reduction or withdrawal of catecholamine and vasopressor support. It improved urine output without causing hyponatremia in adults and children [4,7,[14][15][16][17][18]23]. Data on the use of vasopressin in neonates with vasodilatory shock is limited [14,18] and indications and dosing have not been established.…”

Pediatric Shock

“…(37) In adult septic shock, vasopression levels are low and this finding is thought to contribute to vasodilatation. (38) While this finding is not consistently noted in children (39,40), vasopressin has been shown to improve hemodynamics in neonates with post-cardiopulmonary bypass vasodilatatory shock. (41) Use of vasopressin in other types of shock is still controversial but might be considered as rescue therapy in refractory hypotension as an adjuvant to existing inotropes.…”