Vasopressin effective in reversing catecholamine-resistant vasodilatory shock.
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.
Lim
T W
TW
Department of Anaesthesia and Surgical Intensive Care, Changi General Hospital, Singapore.
Lee
S
S
NG
K S
KS
D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D000368:Aged; D001064:Appendicitis / Q000150:complications; D002316:Cardiotonic Agents / Q000627:therapeutic use; D004280:Dobutamine / Q000008:administration & dosage / Q000627:therapeutic use; D004298:Dopamine / Q000627:therapeutic use; D006801:Humans; D007262:Infusions, Intravenous; D007416:Intestinal Perforation / Q000150:complications; D007423:Intra-Aortic Balloon Pumping; D007431:Intraoperative Complications; D008297:Male; D009203:Myocardial Infarction / Q000150:complications; D009638:Norepinephrine / Q000008:administration & dosage / Q000627:therapeutic use; D020127:Recovery of Function; D012769:Shock / Q000188:drug therapy* / Q000209:etiology; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*; D014664:Vasodilation / Q000187:drug effects; D014667:Vasopressins / Q000627:therapeutic use*
D000316:Adrenergic alpha-Agonists; D000318:Adrenergic beta-Agonists; D002316:Cardiotonic Agents; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D004280:Dobutamine; D004298:Dopamine; D009638:Norepinephrine