The role of vasopressin in cardiorespiratory arrest and pulmonary hypertension.
Vasopressin is a peptide synthesized in the hypothalamus whose primary role is in fluid homeostasis. It has recently gained interest as a potential agent in the treatment of cardiorespiratory arrest. Initial human studies have shown benefits with vasopressin in patients with out of hospital ventricular fibrillation and asystolic cardiac arrest. One subgroup of patients not included in these trials is patients with pulmonary hypertension, who have a five-year mortality rate of 50%. Animal studies have shown vasopressin to be a vasodilator in the pulmonary vascular system of rats, under normoxic and hypoxic conditions, with conflicting results in canines. Human studies have shown conflicting results with increases, decreases and no changes seen in pulmonary artery pressures of patients with a variety of clinical conditions. Research needs to be done in patients with pulmonary hypertension regarding the potential role of vasopressin during cardiac arrest in this subgroup.
Hormone and Vascular Biology Group, Academic Unit of Endocrinology, Div. of Genomic Medicine, University of Sheffield, Sheffield S10 2JF, UK.
A M
AM
Smith
C M
CM
Elliot
D G
DG
Kiely
K S
KS
Channer
D000818:Animals; D004285:Dogs; D006323:Heart Arrest / Q000150:complications / Q000188:drug therapy*; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000188:drug therapy*; D011652:Pulmonary Circulation / Q000187:drug effects; D051381:Rats; D012131:Respiratory Insufficiency / Q000150:complications / Q000188:drug therapy; D013552:Swine; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*; D014667:Vasopressins / Q000627:therapeutic use*
D006490:Hemostatics; D014662:Vasoconstrictor Agents; D014667:Vasopressins