Vasopressin treatment of verapamil toxicity in the porcine model.
BACKGROUND
Vasopressin is a novel vasopressor agent used for intractable hypotension. There is little published data available on its use in the poisoned patient. We performed a randomized, controlled, blinded trial in a porcine model to study the effects of vasopressin infusion on mean arterial pressure after verapamil poisoning.


METHODS
Eighteen anesthetized monitored swine received a verapamil infusion of 1 mg/kg/hr until the mean arterial pressure (MAP) had decreased to 70% of baseline. At this time, a continuous infusion of either vasopressin (0.01 U/kg/min) or an equal volume of normal saline was initiated. The swine were monitored for 60 minutes after initiation of the study infusion. The primary outcome was MAP.


RESULTS
There was no statistically significant difference between the two groups in MAP, cardiac output or systemic vascular resistance. One half (four of eight) of the animals in the vasopressin group died, compared with 20% (two of ten) of those in the saline group.


CONCLUSIONS
Vasopressin infusion decreased the survival of verapamil-poisoned swine when compared to those treated with saline alone in this experimental model.
Barry
J Dave
JD
Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA. JDave.Barry@us.army.mil
Durkovich
Dave
D
Cantrell
Lee
L
Richardson
William
W
Tong
Tri
T
Offerman
Steve
S
Clark
Richard F
RF
Tanen
David A
DA
Williams
Saralyn
S
D000818:Animals; D000931:Antidotes / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002302:Cardiac Output / Q000187:drug effects / Q000502:physiology; D004195:Disease Models, Animal; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D008136:Longevity / Q000187:drug effects; D008297:Male; D011041:Poisoning / Q000188:drug therapy* / Q000378:metabolism; D016037:Single-Blind Method; D013552:Swine; D014662:Vasoconstrictor Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000493:pharmacokinetics / Q000506:poisoning*; D014667:Vasopressins / Q000493:pharmacokinetics / Q000627:therapeutic use*; D014700:Verapamil / Q000493:pharmacokinetics / Q000506:poisoning*
D000931:Antidotes; D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents; D014667:Vasopressins; D014700:Verapamil