Vasopressin for the Treatment of Refractory Hypotension After Cardiopulmonary Bypass

Overand, P. T.; Teply, Joseph F.

doi:10.1213/00000539-199806000-00012

Cited by 26 publications

(9 citation statements)

References 21 publications

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“…The AVPR1a-agonist vasopressin or terlipressin are used in postoperative bowel distention, refractory hypotension after cardiac surgery [25] or to treat intraoperative hypotension or treatment of portal hypertension [26]. AVP experienced a renaissance for treatment of hypovolemic or septic shock [5], refractory hypotension or in resuscitation [12,27]. The finely tuned and independent work mechanisms of AVP on it's different receptors make it the ideal drug for treatment of patients after cardiac surgery suffering from low systemic resistance concomitant with pulmonary hypertension [28], since it elevates systemic resistance while parallel decreasing pulmonary hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…desmopressin, a V2 receptor agonist is used in diagnostics and treatment of diabetes insipidus or used for treatment of coagulopathies [11]. Vasopressin or terlipressin are used in postoperative bowel distention or refractory hypotension after cardiac surgery [12]. AVP gained more interest over the years in treatment of vasoplegic septic shock or other forms of refractory vasoplegic catecholamie resistent shock.…”

Section: Introductionmentioning

confidence: 99%

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Vasopressin Increases Cerebral Perfusion Pressure but not Cerebral Blood Flow in Neurosurgical Patients with Catecholamine-Refractory Hypotension: A Preliminary Evaluation Using the Non-Invasive Quantix ND in Comparison to the Literature

Bele¹

2014

JACCOA

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Vasopressin Increases Cerebral Perfusion Pressure but not Cerebral Blood Flow in Neurosurgical Patients with Catecholamine-Refractory Hypotension: A Preliminary Evaluation Using the Non-Invasive Quantix ND in Comparison to the Literature

Bele¹

2014

JACCOA

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“…22,23 Several mechanisms may explain this improvement of myocardial performance during AVP infusion. First, study patients received significantly lower NE dosages, which are known to have cardiotoxic and proarrhythmic effects.…”

Section: Discussionmentioning

confidence: 99%

Arginine Vasopressin in Advanced Vasodilatory Shock

et al. 2003

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Background-Vasodilatory shock is a potentially lethal complication of severe disease in critically ill patients. Currently, catecholamines are the most widely used vasopressor agents to support blood pressure, but loss of catecholamine pressor effects is a well-known clinical dilemma. Arginine vasopressin (AVP) has recently been shown to be a potent vasopressor agent to stabilize cardiocirculatory function even in patients with catecholamine-resistant vasodilatory shock. Methods and Results-Forty-eight patients with catecholamine-resistant vasodilatory shock were prospectively randomized to receive a combined infusion of AVP and norepinephrine (NE) or NE infusion alone. In AVP patients, AVP was infused at a constant rate of 4 U/h. Hemodynamic, acid/base, single-organ, and tonometrically derived gastric variables were reported before the study and 1, 12, 24, and 48 hours after study entry. For statistical analysis, a mixed-effects model was used. AVP patients had significantly lower heart rate, NE requirements, and incidence of new-onset tachyarrhythmias than NE patients. Mean arterial pressure, cardiac index, stroke volume index, and left ventricular stroke work index were significantly higher in AVP patients. NE patients developed significantly more new-onset tachyarrhythmias than AVP patients (54.3% versus 8.3%). Gastrointestinal perfusion as assessed by gastric tonometry was better preserved in AVP-treated patients. Total bilirubin concentrations were significantly higher in AVP patients. Conclusions-The

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“…In the few case reports and series of its use in the treatment of vasodilatory shock, vasopressin has been found to be effective as a pressor 12,18,20 . Complications such as myocardial or mesenteric ischaemia have not been reported.…”

Section: Discussionmentioning

confidence: 99%

Vasopressin Effective in Reversing Catecholamine-Resistant Vasodilatory Shock

Lim

Lee

2000

Anaesth Intensive Care

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A patient with perforated appendicitis developed progressive vasodilatory shock which was complicated by perioperative acute myocardial infarction. Cardiovascular support included dopamine infusion, and later, intra-aortic balloon counterpulsation balloon pump and noradrenaline and dobutamine infusion. Vasopressin was introduced as a final attempt to reverse the refractory shock and was associated with recovery. The experience with this case suggests that vasopressin may be a valuable adjunct to the treatment of catecholamine-resistant vasodilatory shock.

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Vasopressin for the Treatment of Refractory Hypotension After Cardiopulmonary Bypass

Cited by 26 publications

References 21 publications

Vasopressin Increases Cerebral Perfusion Pressure but not Cerebral Blood Flow in Neurosurgical Patients with Catecholamine-Refractory Hypotension: A Preliminary Evaluation Using the Non-Invasive Quantix ND in Comparison to the Literature

Vasopressin Increases Cerebral Perfusion Pressure but not Cerebral Blood Flow in Neurosurgical Patients with Catecholamine-Refractory Hypotension: A Preliminary Evaluation Using the Non-Invasive Quantix ND in Comparison to the Literature

Arginine Vasopressin in Advanced Vasodilatory Shock

Vasopressin Effective in Reversing Catecholamine-Resistant Vasodilatory Shock

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