title: Low-dose vasopressin in the treatment of septic shock in sheep.
abstract: After induction of cecal perforation, 20 anesthetized sheep were randomized to be treated, when arterial blood pressure fell below 75 mm Hg, with vasopressin (fixed dose of 0.02 U/minute), norepinephrine (0.5-5 microg/kg/minute titrated to maintain mean arterial pressure between 75 and 85 mm Hg), vasopressin + norepinephrine (vasopressin at fixed dose 0.01 U/minute plus norepinephrine titrated as for norepinephrine only group), or no vasopressor (Ringer's lactate [control]). Mean arterial pressure was well maintained in all treatment groups. Superior mesenteric arterial blood flow was significantly lower in the vasopressin + norepinephrine group than in the vasopressin group. Vasopressin alone or combined with norepinephrine limited the increase in blood lactate concentration and ileal PCO2-gap compared with control and norepinephrine groups. Urine output was higher in the vasopressin group than in control and norepinephrine groups. Survival time was longer in the vasopressin (30 +/- 6 hours) and vasopressin + norepinephrine (30 +/- 3 hours) groups than in the norepinephrine group (20 +/- 1 hours, p < 0.05) and in all treatment groups than in the control group (17 +/- 2 hours, p < 0.05). Tissue injury was less severe in the vasopressin and vasopressin + norepinephrine groups than in the others. In this clinically relevant model of septic shock due to peritonitis, vasopressin administration (alone or with norepinephrine) can prolong survival.
authors.affiliation: Ph.D. Department of Intensive Care, Erasme University Hospital, Route de Lennik 808, B-1070 Brussels, Belgium.
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Sun
authors.forename: George
authors.initials: G
authors.lastname: Dimopoulos
authors.forename: Duc Nam
authors.initials: DN
authors.lastname: Nguyen
authors.forename: Zizhi
authors.initials: Z
authors.lastname: Tu
authors.forename: Nathalie
authors.initials: N
authors.lastname: Nagy
authors.forename: Anh Dung
authors.initials: AD
authors.lastname: Hoang
authors.forename: Peter
authors.initials: P
authors.lastname: Rogiers
authors.forename: Daniel
authors.initials: D
authors.lastname: De Backer
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002245:Carbon Dioxide / Q000097:blood; D002432:Cecum / Q000293:injuries; D007082:Ileum / Q000098:blood supply; D007416:Intestinal Perforation / Q000150:complications; D007552:Isotonic Solutions; D007773:Lactates / Q000097:blood; D008638:Mesenteric Arteries / Q000187:drug effects; D009638:Norepinephrine / Q000008:administration & dosage / Q000627:therapeutic use; D016016:Proportional Hazards Models; D011897:Random Allocation; D000077325:Ringer's Lactate; D012756:Sheep; D012772:Shock, Septic / Q000188:drug therapy* / Q000652:urine; D013152:Splanchnic Circulation / Q000187:drug effects; D018709:Statistics, Nonparametric; D015996:Survival Rate; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D014667:Vasopressins / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D007552:Isotonic Solutions; D007773:Lactates; D000077325:Ringer's Lactate; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D002245:Carbon Dioxide; D009638:Norepinephrine