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ISSN 2448-8909 (Print)

2003, Number 5

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Med Crit 2003; 17 (5)

Vasopressin: a new therapeutic alternative for the management of critically ill patient

Carrillo ER, Carvajal RR, Hernández AC

Language: Spanish
References: 74
Page: 162-171
PDF size: 121.76 Kb.


ABSTRACT

Several endocrinological alterations have been reported in hemodynamic deterioration associated to refractory vasodilated shock and cardiac arrest. Vasopressin plays a major role in the development of these complications. Vasopressin interacts with three different protein G related receptors denominated V1a, V1b and V2. Experimental and clinical trials have shown the efficacy of vasopressin in the management of septic shock, post-cardiotomy shock, dilated phase of hemorrhagic shock, intoxications and cardiac arrest due to pulseless ventricular tachycardia and ventricular fibrillation.
The recommended dose of vasopressin for management of vasodilated shock is 0.01 to 0.04 UI/minute. Higher doses are associated with myocardial ischemia and cutaneous and splanchnic hypoperfusion. The American Heart Association recommends the use of vasopressin as a bolus of 40 UI in the management of pulseless ventricular tachycardia and ventricular fibrillation; this is considered a IIb recommendation.


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