Arginine vasopressin: a promising rescue drug in the treatment of uncontrolled haemorrhagic shock.
Haemorrhagic shock is one of the most frequent types of shock. If haemorrhage cannot be controlled and fluid resuscitation as well as catecholamines are insufficient to stabilize cardiovascular function, uncontrolled haemorrhagic shock occurs. Several approaches have been suggested as promising alternatives to volume resuscitation. The rationale for the use of arginine vasopressin (AVP) is the pharmacologic amplification of the neuroendocrine stress response. AVP-mediated vasoconstriction is the first physiologic step to haemostasis and shifts blood away from the bleeding site towards the heart, lungs and brain. Particularly, when uncontrolled haemorrhage is accompanied by traumatic brain injury this may help to reduce secondary neurological damage. Since AVP can prevent acute death only transiently, it must comprehensively be combined with rapid hospital admission, immediate control of haemorrhage followed by aggressive fluid resuscitation and blood transfusion. This review article summarizes current experimental and clinical evidence on the use of AVP in uncontrolled haemorrhagic shock.
Wenzel
Volker
V
Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, 6020 Innsbruck, Austria.
Raab
Helmut
H
Dünser
Martin W
MW
D000818:Animals; D001127:Arginine Vasopressin / Q000494:pharmacology / Q000627:therapeutic use*; D001930:Brain Injuries / Q000150:complications / Q000188:drug therapy; D002986:Clinical Trials as Topic; D006801:Humans; D009104:Multiple Trauma / Q000150:complications; D012771:Shock, Hemorrhagic / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D014662:Vasoconstrictor Agents / Q000494:pharmacology / Q000627:therapeutic use*
D014662:Vasoconstrictor Agents; D001127:Arginine Vasopressin