Employing vasopressin as an adjunct vasopressor in uncontrolled traumatic hemorrhagic shock. Three cases and a brief analysis of the literature.
Resuscitation of patients in hemorrhagic shock remains one of the most challenging aspects of trauma care. We showed in experimental studies that vasopressin, but not fluid resuscitation, enabled short-term and long-term survival in a porcine model of uncontrolled hemorrhagic shock after penetrating liver trauma. In this case report, we present two cases with temporarily successful cardiopulmonary resuscitation (CPR) using vasopressin and catecholamines in uncontrolled hemorrhagic shock with subsequent cardiac arrest that was refractory to catecholamines and fluid replacement. In a third patient, an infusion of vasopressin was started before cardiac arrest occurred; in this case, we were able to stabilize blood pressure thus allowing further therapy. The patient underwent multiple surgical procedures, developed multi-organ failure, but was finally discharged from the critical care unit without neurological damage.
Krismer
A C
AC
Department of Anesthesiology and Critical Care Medicine, Medical University, Innsbruck, Austria. anette.krismer@uibk.ac.at
Wenzel
V
V
Voelckel
W G
WG
Innerhofer
P
P
Stadlbauer
K H
KH
Haas
T
T
Pavlic
M
M
Sparr
H J
HJ
Lindner
K H
KH
Koenigsrainer
A
A
D000007:Abdominal Injuries / Q000150:complications; D000058:Accidental Falls; D000063:Accidents, Traffic; D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006323:Heart Arrest / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology / Q000628:therapy; D012771:Shock, Hemorrhagic / Q000188:drug therapy* / Q000209:etiology; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*; D014667:Vasopressins / Q000627:therapeutic use*; D014947:Wounds and Injuries / Q000150:complications*; D014951:Wounds, Stab / Q000150:complications
D014662:Vasoconstrictor Agents; D014667:Vasopressins