The Effects of Vasopressin on Systemic Hemodynamics in Catecholamine-Resistant Septic and Postcardiotomy Shock: A Retrospective Analysis

Dünser, Martin W.; Mayr, Andreas; Ulmer, Hanno; Ritsch, Nicole; Knotzer, Hans; Pajk, Werner; Luckner, Günter; Mutz, N.; Hasibeder, Walter

doi:10.1097/00000539-200107000-00003

Cited by 237 publications

(150 citation statements)

References 21 publications

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“…We did not observe evidence of myocardial ischemia in any of the patients during the 24 hour study period, which is in accordance with other studies [12]. Ischaemic skin lesions have been reported in patients receiving vasopressin treatment [13,14].…”

Section: Discussionsupporting

confidence: 92%

Effects of Low Dose Vasopressin in Catecholamine Resistant Septic Shock

Sharma

Setlur

Prabhakaran³

et al. 2008

Medical Journal Armed Forces India

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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

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Section: Discussionsupporting

confidence: 92%

Effects of Low Dose Vasopressin in Catecholamine Resistant Septic Shock

Sharma

Setlur

Prabhakaran³

et al. 2008

Medical Journal Armed Forces India

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“…Comparisons of the hemodynamic effects of angiotensin II with vasopressin derivatives are not possible based on these data. Previous studies, however, reported consistent increases of both systemic vascular resistance and arterial blood pressure during arginine vasopressin infusion in patients with advanced vasodilatory shock and norepinephrine requirements >0.5 µg/kg/min (6).…”

mentioning

confidence: 78%

Vasopressor hormones in shock—noradrenaline, vasopressin or angiotensin II: which one will make the race?

Dünser

Meier

2017

J. Thorac. Dis.

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“…22,23 Reductions in systemic blood pressure are known and may require concurrent administration of vasopressors. 23 However, the importance of maintaining systemic blood pressure and, subsequently, right coronary pressure and flow in the face of RV dysfunction may not be as well appreciated.…”

Section: Managing Rv Failurementioning

confidence: 99%

“…9 Although the use of vasopressors can be beneficial, its prolonged administration can also contribute to systemic organ failure. 22 Specifically, prolonged administration (more than 48 h) of vasopressin has been linked to hepatic failure, renal failure, and thrombocytopenia. 22 For the case presented, systemic organ dysfunction seemed to be related, at least in part, to prolonged administration of vasopressin and not failure of the RV to eject.…”

Section: Managing Rv Failurementioning

confidence: 99%

“…22 Specifically, prolonged administration (more than 48 h) of vasopressin has been linked to hepatic failure, renal failure, and thrombocytopenia. 22 For the case presented, systemic organ dysfunction seemed to be related, at least in part, to prolonged administration of vasopressin and not failure of the RV to eject. After considering the benefits of PVSM on right heart ejection, the milrinone infusion was discontinued to allow return of native vasomotor tone.…”

Section: Managing Rv Failurementioning

confidence: 99%

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Case report: paradoxical ventricular septal motion in the setting of primary right ventricular myocardial failure

Maslow

Schwartz

Mahmood

et al. 2009

Can J Anesth/J Can Anesth

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Purpose In this report, a case of right ventricular (RV) failure, hemodynamic instability, and systemic organ failure is described to highlight how paradoxical ventricular systolic septal motion (PVSM), or a rightward systolic displacement of the interventricular septum, may contribute to RV ejection. Clinical features Multiple inotropic medications and vasopressors were administered to treat right heart failure and systemic hypotension in a patient following combined aortic and mitral valve replacement. In the early postoperative period, echocardiographic evaluation revealed adequate left ventricular systolic function, akinesis of the RV myocardial tissues, and PVSM. In the presence of PVSM, RV fractional area of contraction was C35% despite akinesis of the primary RV myocardial walls. The PVSM appeared to contribute toward RV ejection. As a result, the need for multiple inotropes was re-evaluated, in considering that end-organ dysfunction was the result of systemic hypotension and prolonged vasopressor administration. After discontinuation of phosphodiesterase inhibitors, native vascular tone returned and the need for vasopressors declined. This was followed by recovery of systemic organ function. Echocardiographic re-evaluation two years later, revealed persistent akinesis of the RV myocardial tissues and PVSM, the latter appearing to contribute toward RV ejection. Conclusions This case highlights the importance of left to RV interactions, and how PVSM may mediate these hemodynamic interactions. RésuméObjectif Dans ce compte-rendu, un cas de de´faillance ventriculaire droite (VD), d'instabilite´he´modynamique et de de´faillance organique syste´mique est de´crit afin de souligner la manie`re dont le mouvement systolique paradoxal du septum interventriculaire (PVSM), ou un de´placement systolique de la cloison interventriculaire vers la droite, peut jouer un rôle dans l'e´jection du VD. É léments cliniques De nombreux me´dicaments inotropes et vasopresseurs ont e´te´administre´s pour traiter une de´faillance cardiaque droite ainsi qu'une hypotension syste´mique chez un patient a`la suite d'une chirurgie valvulaire aortique et mitrale combine´e. Au de´but de la pe´riode postope´ratoire, l'e´valuation e´chocardiographique a re´ve´le´une fonction systolique ade´quate du ventricule Electronic supplementary material The online version of this article

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The Effects of Vasopressin on Systemic Hemodynamics in Catecholamine-Resistant Septic and Postcardiotomy Shock: A Retrospective Analysis

Cited by 237 publications

References 21 publications

Effects of Low Dose Vasopressin in Catecholamine Resistant Septic Shock

Effects of Low Dose Vasopressin in Catecholamine Resistant Septic Shock

Vasopressor hormones in shock—noradrenaline, vasopressin or angiotensin II: which one will make the race?

Case report: paradoxical ventricular septal motion in the setting of primary right ventricular myocardial failure

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