Carrillo-Esper R, Carvajal-Ramos R

Language: Spanish
References: 84
Page: 157-166
PDF size: 95.80 Kb.

ABSTRACT

Vasopressin deficiency is common in refractory vasodilated shock. Vasopressinacts by means of three different receptors related to G protein, known as V_1a, V_1b and V₂. Experimental and clinical trials have shown the usefulness of vasopressin in the management of septic shock; postoperative shock after heart surgery; the dilated phase of hemorrhagic shock; intraopera hypotension induced by ACE inhibitors and milrinone; pulseless cardiac arrest and ventricular tachycardia; and ventricular fibrillation. The recommended dose of vasopressin for the management of vasodilated shock is 0.01 to 0.04 IU/minute. Higher doses are associated with myocardial ischemia and cutaneous and splanchnic hypoperfusion.Terlipressin in a single, 1-mg dose is the first-choice treatment for intraoperatory hypotension induced by ACE inhibitors and milrinone. The American Heart Association recommends the use of vasopressin as a bolus of 40 IU in the management of pulseless ventricular tachycardia and ventricular fibrillation; this is considered a IIb recommendation.

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