Role of desmopressin in the treatment of a case of septic shock refractory to catecholamines.
The authors describe a case of septic shock refractory to high-dose catecholamines after adequate volemic filling, rapidly corrected with the administration of desmopressin at a dose of 0.02 U/min. There are, in the literature, several cases of septic shock refractory to high-dose catecholamines successfully treated with arginine-vasopressin, a selective V1 agonist. This agent can potentially induce coronary vasoconstriction and presents a very difficult weaning, that imposes a slow reduction of the infusion amount. On the contrary, desmopressin does not present those adverse effects and is able to maintain a high renal blood flow, for its prevalent action on V2 instead of V1 receptors.
Mignani
V
V
Department of Anesthesia and Resuscitation, Catholic University of the Sacred Heart, Rome, Italy.
Poleggi
P
P
Conti
G
G
Pennisi
M A
MA
Marchese
M
M
D000368:Aged; D002395:Catecholamines / Q000627:therapeutic use*; D003894:Deamino Arginine Vasopressin / Q000009:adverse effects / Q000627:therapeutic use*; D004351:Drug Resistance; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D012772:Shock, Septic / Q000188:drug therapy*
D002395:Catecholamines; D007004:Hypoglycemic Agents; D003894:Deamino Arginine Vasopressin