title: The effect of vasopressin on gastric perfusion in catecholamine-dependent patients in septic shock.
abstract: OBJECTIVE
  To study the effect of continuous infusion of vasopressin on the splanchnic circulation in patients with severe septic shock.
  
  
  METHODS
  Prospective clinical study.
  
  
  METHODS
  ICU in a teaching hospital.
  
  
  METHODS
  Eleven consecutive patients with documented septic shock who remained hypotensive despite norepinephrine infusion at a rate > or =0.2 microg/kg/min.
  
  
  METHODS
  Insertion of a gastric tonometry catheter, and continuous infusion of vasopressin 0.04 U/min during 4 h.
  
  
  RESULTS
  Difference between gastric and arterial CO(2) partial pressure (P[g-a]CO(2) gap), mean arterial pressure, and cardiac index were recorded at baseline and after 15 min, 30 min, 60 min, 120 min, and 240 min.
  
  
  RESULTS
  The median P(g-a)CO(2) gap increased from 5 mm Hg at baseline to 19 mm Hg after 4 h (p = 0.022). Mean arterial pressure increased from 61 +/- 13 mm Hg at baseline to 68 +/- 9 mm Hg after 4 h (p = 0.055). No significant changes in cardiac index were noted.
  
  
  CONCLUSIONS
  In norepinephrine-dependent patients in septic shock, continuous infusion of low-dose vasopressin results in a significant increase of the P(g-a)CO(2) gap compatible with GI hypoperfusion.
authors.affiliation: Department of Intensive Care Medicine, Jeroen Bosch Hospital, PO Box 90153, 5200 ME 's-Hertogenbosch, the Netherlands. fvharen@planet.nl
authors.forename: Frank M P
authors.initials: FM
authors.lastname: van Haren
authors.forename: Frans W
authors.initials: FW
authors.lastname: Rozendaal
authors.forename: Johannes G
authors.initials: JG
authors.lastname: van der Hoeven
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D003422:Critical Care; D005260:Female; D006801:Humans; D007022:Hypotension / Q000188:drug therapy*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009638:Norepinephrine / Q000627:therapeutic use*; D011014:Pneumonia / Q000150:complications; D011446:Prospective Studies; D012772:Shock, Septic / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D013152:Splanchnic Circulation / Q000187:drug effects*; D014662:Vasoconstrictor Agents / Q000097:blood / Q000627:therapeutic use*; D014667:Vasopressins / Q000097:blood / Q000627:therapeutic use*
chemical_list: D014662:Vasoconstrictor Agents; D014667:Vasopressins; D009638:Norepinephrine