Vasopressin in the cardiac surgery intensive care unit.
Although nearly 10% of patients experience profound vasodilatory shock after cardiopulmonary bypass, some patients remain refractory to traditional resuscitation. Among this subset are patients who have inappropriately low levels of endogenous vasopressin. Thus, vasopressin replacement is an intuitively attractive intervention. The purposes of this review are to outline the pathophysiology of vasodilatory shock after cardiopulmonary bypass, to discuss the physiological role of endogenous vasopressin, to explore the clinical basis for vasopressin replacement, and to review the pharmacology and dosing guidelines.
Albright
Tracy N
TN
Cardiothoracic Surgery Service, Veterans Administration Medical Center, Denver, Colo, USA.
Zimmerman
Michael A
MA
Selzman
Craig H
CH
D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D003325:Coronary Care Units; D004496:Education, Continuing; D006801:Humans; D017410:Practice Guidelines as Topic; D012773:Shock, Surgical / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D014481:United States; D014667:Vasopressins / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*
D014667:Vasopressins