Effect of vasopressin on sublingual microcirculation in a patient with distributive shock.
OBJECTIVE
To assess the sublingual microcirculation in a patient during vasopressin administration for a distributive shock after cardiopulmonary bypass.


METHODS
Case-report in the Department of Intensive Care of a university hospital.


METHODS
A 53 year-old man developed severe distributive shock after cardiac transplant, requiring massive doses of vasopressor agents.


METHODS
Vasopressin administered twice at a dose of 0.02 U/min increased mean blood pressure and allowed partial weaning of other vasopressor drugs. Microcirculatory alterations were assessed by orthogonal polarization spectral technique: 50% and 60% of capillaries were perfused at baseline, and these proportions did not worsen when vasopressin was administered.


CONCLUSIONS
Despite its strong vasopressor effects vasopressin infusion did not worsen microcirculatory alterations in this patient with distributive shock following cardiac surgery.
Department of Intensive Care Medicine, Erasme Hospital, Route de Lennik 808, 1070, Brussels, Belgium.
Marc J
MJ
Dubois
Department of Intensive Care Medicine, Erasme Hospital, Route de Lennik 808, 1070, Brussels, Belgium. ddebacke@ulb.ac.be.
Daniel
D
De Backer
Department of Intensive Care Medicine, Erasme Hospital, Route de Lennik 808, 1070, Brussels, Belgium.
Jacques
J
Creteur
Department of Intensive Care Medicine, Erasme Hospital, Route de Lennik 808, 1070, Brussels, Belgium.
Sami
S
Anane
Department of Intensive Care Medicine, Erasme Hospital, Route de Lennik 808, 1070, Brussels, Belgium.
Jean-Louis
JL
Vincent
D001794:Blood Pressure / Q000187:drug effects; D009202:Cardiomyopathies / Q000601:surgery; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002496:Central Venous Pressure / Q000187:drug effects; D005454:Fluorescence Polarization; D006339:Heart Rate / Q000187:drug effects; D016027:Heart Transplantation / Q000009:adverse effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008833:Microcirculation / Q000187:drug effects*; D008875:Middle Aged; D009060:Mouth Floor / Q000098:blood supply*; D010101:Oxygen Consumption / Q000187:drug effects; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D012770:Shock, Cardiogenic / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D013050:Spectrometry, Fluorescence; D014662:Vasoconstrictor Agents / Q000494:pharmacology / Q000627:therapeutic use*; D014667:Vasopressins / Q000494:pharmacology / Q000627:therapeutic use*
D014662:Vasoconstrictor Agents; D014667:Vasopressins