R M Sharma1, R Setlur2, K Prabhakaran3, A Rai4. 1. Classified Specialist (Anaesthesiology & Critical Care), 5 Air Force Hospital, C/o 99 APO. 2. Reader (Department of Anaesthesiology & Critical Care), AFMC, Pune-411040. 3. Classified Specialist (Neuro-Anaesthesiology) 166 MH, C/O 56 APO. 4. Graded Specialist (Anaesthesiology), MH-Ranikhet.
Abstract
BACKGROUND: Septic shock commonly leads to death in critically ill patients. Severe hypotension resistant to conventional catecholamine leads to multiorgan failure. We studied the effectiveness of low dose vasopressin in resistant septic shock. METHODS: Thirty critically ill patients with catecholamine resistant hypotension were included in the study. After adequate fluid resuscitation, infusion of norepinephrine and dobutamine was started. If the patient remained hypotensive, vasopressin was infused at a fixed rate of 0.04 unit/minute for 24 hours. Haemodynamic parameters and mortality rates were recorded. RESULT: There was a significant improvement in systolic and mean arterial pressure within four hours of starting vasopressin. This improvement continued throughout the 24-hour period. In addition, it was possible to withdraw dopamine in all the patients and significantly reduce infusion rates of dobutamine and norepinephrine. No significant complication was noted. CONCLUSION: Low dose vasopressin at the rate of 0.04 unit/minute is an effective vasopressor in adult patients with catecholamine resistant septic shock.
BACKGROUND:Septic shock commonly leads to death in critically illpatients. Severe hypotension resistant to conventional catecholamine leads to multiorgan failure. We studied the effectiveness of low dose vasopressin in resistant septic shock. METHODS: Thirty critically illpatients with catecholamine resistant hypotension were included in the study. After adequate fluid resuscitation, infusion of norepinephrine and dobutamine was started. If the patient remained hypotensive, vasopressin was infused at a fixed rate of 0.04 unit/minute for 24 hours. Haemodynamic parameters and mortality rates were recorded. RESULT: There was a significant improvement in systolic and mean arterial pressure within four hours of starting vasopressin. This improvement continued throughout the 24-hour period. In addition, it was possible to withdraw dopamine in all the patients and significantly reduce infusion rates of dobutamine and norepinephrine. No significant complication was noted. CONCLUSION: Low dose vasopressin at the rate of 0.04 unit/minute is an effective vasopressor in adult patients with catecholamine resistant septic shock.
Entities:
Keywords:
Septic shock; Severe sepsis; Vasopressin
Authors: E Rivers; B Nguyen; S Havstad; J Ressler; A Muzzin; B Knoblich; E Peterson; M Tomlanovich Journal: N Engl J Med Date: 2001-11-08 Impact factor: 91.245
Authors: M W Dünser; A J Mayr; H Ulmer; N Ritsch; H Knotzer; W Pajk; G Luckner; N J Mutz; W R Hasibeder Journal: Anesth Analg Date: 2001-07 Impact factor: 5.108
Authors: Mitchell M Levy; Mitchell P Fink; John C Marshall; Edward Abraham; Derek Angus; Deborah Cook; Jonathan Cohen; Steven M Opal; Jean-Louis Vincent; Graham Ramsay Journal: Intensive Care Med Date: 2003-03-28 Impact factor: 17.440
Authors: R Phillip Dellinger; Jean M Carlet; Henry Masur; Herwig Gerlach; Thierry Calandra; Jonathan Cohen; Juan Gea-Banacloche; Didier Keh; John C Marshall; Margaret M Parker; Graham Ramsay; Janice L Zimmerman; Jean-Louis Vincent; Mitchell M Levy Journal: Crit Care Med Date: 2004-03 Impact factor: 7.598