title: The pivotal role of vasopressin in refractory anaphylactic shock.
abstract: BACKGROUND
  Severe anaphylaxis can be associated with cardiovascular collapse that is difficult to manage and does not respond to treatment with epinephrine. Because anaphylaxis is uncommon, unpredictable and may be fatal, a prospective, randomized, controlled trial in humans on the best management is difficult and guidelines are based on theory and anecdotes only.
  
  
  RESULTS
  We report six cases in which the use of vasopressin was successful in the treatment of anaphylactic shock.
  
  
  CONCLUSIONS
  Standard treatment of anaphylactic shock, including discontinuation of the causative agent, administration of epinephrine, and infusion of IV fluids, did not stabilize cardiocirculatory function, and adding arginine vasopressors resulted in prompt hemodynamic stabilization.
authors.affiliation: Department for Anesthesiology and Intensive Care Medicine, SRH Zentralklinikum Suhl, Albert-Schweitzer str. 2, 98527 Suhl, Germany. cwsm.schummer@gmx.de
authors.forename: Claudia
authors.initials: C
authors.lastname: Schummer
authors.forename: Melanie
authors.initials: M
authors.lastname: Wirsing
authors.forename: Wolfram
authors.initials: W
authors.lastname: Schummer
mesh_terms: D000368:Aged; D000707:Anaphylaxis / Q000139:chemically induced / Q000188:drug therapy*; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*; D014667:Vasopressins / Q000627:therapeutic use*
chemical_list: D014662:Vasoconstrictor Agents; D014667:Vasopressins; D004837:Epinephrine