The effects of vasopressin on hemodynamics and renal function in severe septic shock: a case series

Holmes, Cheryl L.; Walley, Keith R.; Chittock, Dean R.; Lehman, Tara; Russell, James A.

doi:10.1007/s001340101014

Cited by 299 publications

(193 citation statements)

References 23 publications

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“…These results are consistent with previous small studies showing that vasopressin compared to norepinephrine increased urine output and creatinine clearance [9][10][11][12].…”

Section: Comparison Of Vasopressin V Norepinephrinesupporting

confidence: 93%

“…In addition to its potent vasoconstrictor effects, vasopressin may also have specific beneficial effects on renal function secondary to its binding to a family of vasopressin receptors [8]. In several small studies of vasodilatory shock, vasopressin increased glomerular filtration rate, urine output and creatinine clearance [9][10][11][12]. However, to date no large studies have assessed the effect of vasopressin, as compared with norepinephrine, on the outcome of acute kidney injury.…”

Section: Introductionmentioning

confidence: 99%

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The effects of vasopressin on acute kidney injury in septic shock

et al. 2009

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Kidney injury was present in 464 patients (59.6%) at study entry. In patients in the RIFLE "Risk" category (n=106) vasopressin as compared with norepinephrine was associated with a trend to a lower rate of progression to renal "Failure" or "Loss" categories (20.8% v 39.6% respectively, p=0.03), and a lower rate of use of renal replacement therapy (17.0% v 37.7%, p=0.02). Mortality rates in the "Risk" category patients treated with vasopressin compared to norepinephrine were 30.8% v 54.7%, p=0.01, but this did not reach significance in a multiple logistic regression analysis (OR=0.33, 99%CI 0.10-1.09, p=0.02). The interaction of treatment group and RIFLE category was significant in predicting mortality. Conclusions:Vasopressin may reduce progression to renal failure and mortality in patients at risk of kidney injury who have septic shock.

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“…These results are consistent with previous small studies showing that vasopressin compared to norepinephrine increased urine output and creatinine clearance [9][10][11][12].…”

Section: Comparison Of Vasopressin V Norepinephrinesupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

The effects of vasopressin on acute kidney injury in septic shock

et al. 2009

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“…Low doses of vasopressin may be effective in raising blood pressure in patients refractory to other vasopressors and may have other potential physiologic benefits [266][267][268][269][270][271]. Terlipressin has similar effects, but is long-acting [272].…”

Section: G Vasoactive Medicationsmentioning

confidence: 99%

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

et al. 2017

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Objective: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012". Design:A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroups and among the entire committee served as an integral part of the development. Methods:The panel consisted of five sections: hemodynamics, infection, adjunctive therapies, metabolic, and ventilation. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. Each subgroup generated a list of questions, searched for best available evidence, and then followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence from high to very low, and to formulate recommendations as strong or weak, or best practice statement when applicable.

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“…When hypotension persists in a patient already taking a vasopressor medication, vasopressin deficiency may be considered; 123,124 vasopressin is an endogenously produced hormone that is deficient in many patients with septic shock. Exogenously administered vasopressin in physiologic replacement doses (0.01-0.04 units/min) may act synergistically with other vasopressor agents, and has been associated with early withdrawal of other catecholamines.…”

Section: Vasoactive Agentsmentioning

confidence: 99%

Early and innovative interventions for severe sepsis and septic shock: taking advantage of a window of opportunity

Rivers

McIntyre

Morro

et al. 2005

Canadian Medical Association Journal

141

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The effects of vasopressin on hemodynamics and renal function in severe septic shock: a case series

Abstract: In this group of patients with severe septic shock, vasopressin infusion increased MAP and urine output and decreased catecholamine requirements. Doses higher than 0.04 U/min were not associated with increased effectiveness and may have been associated with higher adverse effects.

Cited by 299 publications

References 23 publications

The effects of vasopressin on acute kidney injury in septic shock

The effects of vasopressin on acute kidney injury in septic shock

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

Early and innovative interventions for severe sepsis and septic shock: taking advantage of a window of opportunity

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