Antidiuretic hormone replacement therapy to prevent or ameliorate vasodilatory shock.
Vasodilatory shock is a syndrome with high mortality. It is becoming evident that depletion of antidiuretic hormone (ADH) after cardiac surgery or during sepsis plays an important role in the pathogenesis of this condition. Established vasodilatory shock responds well to exogenous ADH infusion. It is possible that preventing ADH depletion at an earlier stage may abrogate the onset of vasodilatory shock, or at least reduce its severity. This paper examines the evidence supporting this concept, and the potential areas of concern in considering this particular type of hormone replacement therapy.
St. George's Hospital Medical School, London, UK. gsinghranger@yahoo.co.uk
Gurpreet
G
Singh Ranger
D000818:Animals; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D004334:Drug Administration Schedule; D006355:Heart-Lung Machine; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000517:prevention & control; D007262:Infusions, Intravenous; D023421:Models, Animal; D011673:Pulsatile Flow; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012449:Safety; D012772:Shock, Septic / Q000097:blood / Q000503:physiopathology; D012773:Shock, Surgical / Q000097:blood / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D014664:Vasodilation; D014667:Vasopressins / Q000097:blood / Q000172:deficiency / Q000627:therapeutic use*
D014667:Vasopressins