Dear vasopressin, where is your place in septic shock?
Cardiovascular failure is one of the central therapeutic problems in patients with severe infection. Although norepinephrine is a potent and, in most cases, highly effective vasopressor agent, very high dosages leading to significant side effects can be necessary to stabilize advanced shock. As a supplementary vasopressor, arginine vasopressin can reverse hemodynamic failure and significantly decrease norepinephrine dosages. Whether the promising possibility of 'bridging' advanced septic shock when the benefit/risk ratio of catecholamine therapy leaves a clinically tolerable range may improve quantitative and qualitative patient outcome can only be determined by a large, prospective, randomized study.
Duenser
Martin W
MW
Division of General and Surgical Intensive Care Medicine, Department of Anesthesiology and Critical Care Medicine, The Medical University of Innsbruck, Austria. csab3987@uibk.ac.at
Hasibeder
Walter R
WR
D001127:Arginine Vasopressin / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D002395:Catecholamines / Q000627:therapeutic use; D003422:Critical Care; D004359:Drug Therapy, Combination; D006439:Hemodynamics / Q000187:drug effects; D020249:Hormone Replacement Therapy; D006801:Humans; D009638:Norepinephrine / Q000008:administration & dosage / Q000627:therapeutic use; D012772:Shock, Septic / Q000188:drug therapy* / Q000503:physiopathology; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*
D002395:Catecholamines; D014662:Vasoconstrictor Agents; D001127:Arginine Vasopressin; D009638:Norepinephrine