The physiological effects of vasopressin when used to control intra-abdominal bleeding.
Vasopressin was used in ten critically ill patients with massive intra-abdominal bleeding unresponsive to conventional therapy. Vasopressin controlled bleeding in four patients, three of whom had continued to bleed following laparotomy for haemostasis; in two other patients, bleeding was reduced. All the patients were intensively monitored throughout the period of the vasopressin treatment; this enabled other physiological effects of vasopressin to be documented and reported. Mean arterial pressure and central venous pressure increased following the administration of vasopressin and there was a decrease in heart rate. Core body temperature rose significantly. Although all the patients had impaired renal function before receiving vasopressin, five had a prompt diuresis following its administration. Eight patients died but only three of intra-abdominal bleeding; two patients survived to leave hospital. Four patients had post-mortem evidence of ischaemia in the heart, liver and gastrointestinal tract; vasopressin may have contributed to the development of this. Vasopressin may have a place in the management of patients with life-threatening intra-abdominal haemorrhage but its use should be confined to those patients in whom conventional therapy has failed.
Shelly
M P
MP
Addenbrooke's Hospital, Cambridge, UK.
Greatorex
R
R
Calne
R Y
RY
Park
G R
GR
D000005:Abdomen; D000293:Adolescent; D000328:Adult; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy*; D013997:Time Factors; D014667:Vasopressins / Q000627:therapeutic use*
D014667:Vasopressins