The long-term survival rate of catecholamine-resistant septic shock in Japanese patients who received vasopressin therapy.
BACKGROUND
Septic shock is associated with vasopressin deficiency and hypersensitivity to its exogenous administration. The aim of this study is to review the 28-day survival rate, hemodynamic and renal effects of vasopressin therapy in refractory septic shock Japanese patients.


METHODS
55 Japanese patients experiencing catecholamine-resistant septic shock were treated with vasopressin. Hemodynamic alterations and the serum concentrations of aspartate aminotransferase, total bilirubin and creatinine clearance were evaluated following vasopressin treatment.


RESULTS
In both, survivors and non-surviving patients, treatment with vasopressin resulted in a significantly increase in mean arterial pressure, hourly urine output, and a significant decrease in heart rate and total pressor dosage requirements. Creatinine clearance was significantly increased only in survivors. There were no significant changes in the serum concentrations of aspartate aminotransferase and total bilirubin. The 28-day survival rate was 45% (25 patients).


CONCLUSIONS
In Japanese septic shock patients, vasopressin infusion improved hemodynamic status and reduced catecholamine requirement, and 28-day survival rate was 45%.
Sawa
N
N
Departments of Nephrology, Toranomon Hospital, Tokyo, Japan. naokis@toranomon.gr.jp
Ubara
Y
Y
Katori
H
H
Hoshino
J
J
Suwabe
T
T
Takemoto
F
F
Uchida
N
N
Masuoka
K
K
Wake
A
A
Taniguchi
S
S
Takaichi
K
K
D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002316:Cardiotonic Agents / Q000494:pharmacology; D004298:Dopamine / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000401:mortality* / Q000503:physiopathology; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D007262:Infusions, Intravenous; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D009638:Norepinephrine / Q000494:pharmacology*; D011446:Prospective Studies; D012772:Shock, Septic / Q000188:drug therapy / Q000401:mortality* / Q000503:physiopathology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D014667:Vasopressins / Q000008:administration & dosage*
D002316:Cardiotonic Agents; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D004298:Dopamine; D009638:Norepinephrine