Effect of vasopressin on hemodynamics in patients with refractory cardiogenic shock complicating acute myocardial infarction.
In a retrospective study of 36 patients who developed cardiogenic shock after myocardial infarction, intravenous vasopressin therapy increased mean arterial pressure from 56 to 73 mm Hg at 1 hour (p < 0.001) and maintained it for 24 hours without changing pulmonary capillary wedge pressure, cardiac index, urine output, or other inotropic requirements. After norepinephrine administration, mean pulmonary capillary wedge pressure increased at 1 hour from 21 to 24 mm Hg (p = 0.04); however, this increase was not sustained at 12 and 24 hours. Norepinephrine was associated with a significant increase in cardiac power index at 24 hours, whereas there was only a trend for an increase in cardiac power with vasopressin therapy. In a cohort of patients who developed refractory cardiogenic shock after myocardial infarction, vasopressin was associated with increased mean arterial pressure and no adverse effect on other hemodynamic parameters.
Jolly
Sanjit
S
The Interventional Cardiology Program, Division of Cardiology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Newton
Gary
G
Horlick
Eric
E
Seidelin
Peter H
PH
Ross
Heather J
HJ
Husain
Mansoor
M
Dzavik
Vladimir
V
D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D002302:Cardiac Output / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology; D009638:Norepinephrine / Q000627:therapeutic use; D011669:Pulmonary Wedge Pressure / Q000187:drug effects*; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*; D014667:Vasopressins / Q000627:therapeutic use*
D014662:Vasoconstrictor Agents; D014667:Vasopressins; D009638:Norepinephrine