The role of vasopressin in the treatment of vasodilation in shock states.
OBJECTIVE
To review the role of vasopressin in the treatment of vasodilatory shock.


METHODS
A MEDLINE search on published reports (1966-April 1999) was conducted.


METHODS
English-language studies and case reports were selected and evaluated based on quality of review of vasopressin in the treatment of vasodilatory shock.


RESULTS
In patients with end-stage vasodilatory shock, baroreceptor reflex is impaired and vasopressin stores are depleted. Persistent elevation of catecholamines may lead to down-regulation of beta-adrenergic receptors and reduces smooth-muscle response to catecholamines, leading to inability of maintaining organ perfusion. Small-scale studies and case reports have demonstrated vasopressin's efficacy in maintaining blood pressure in patients with septic shock, cardiac arrest, and end-stage heart failure, refractory to other vasopressor therapies.


CONCLUSIONS
Vasopressin may be a reasonable alternative for patients in vasodilatory shock. However, larger-scale controlled dinical trials are warranted before its routine use can be recommended.
Rozenfeld
V
V
Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, NY, USA.
Cheng
J W
JW
D006801:Humans; D012769:Shock / Q000188:drug therapy* / Q000503:physiopathology*; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology*; D014667:Vasopressins / Q000627:therapeutic use*
D014662:Vasoconstrictor Agents; D014667:Vasopressins