title: Arginine vasopressin in septic shock: supplement or substitute for norepinephrine?
abstract: In the current issue of Critical Care, Simon and coworkers investigated the effects of first-line arginine vasopressin (AVP) on organ function and systemic metabolism compared with norepinephrine in a pig model of fecal peritonitis. AVP was titrated according to the mean arterial pressure suggesting a vasopressor rather than a hormone replacement therapy. The study provides some evidence for the safety of this therapeutic approach. It needs to be determined whether AVP is most beneficial as a constant low-dose infusion to supplement norepinephrine or in higher doses than currently recommended to substitute norepinephrine. In addition, future studies are warranted to evaluate whether a first-line therapy of AVP is superior to a last-resort administration.
authors.affiliation: Investigational Intensive Care Unit, Department of Anesthesiology, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USA. serehber@utmb.edu
authors.forename: Sebastian
authors.initials: S
authors.lastname: Rehberg
authors.forename: Perenlei
authors.initials: P
authors.lastname: Enkhbaatar
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Traber
mesh_terms: D000818:Animals; D001127:Arginine Vasopressin / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D064420:Drug-Related Side Effects and Adverse Reactions; D009638:Norepinephrine / Q000627:therapeutic use*; D012772:Shock, Septic / Q000188:drug therapy*; D034421:Sus scrofa; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D014662:Vasoconstrictor Agents; D001127:Arginine Vasopressin; D009638:Norepinephrine
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