[Arginine vasopressin in vasodilatory shock: a new therapy approach?]

Catecholamines are currently the most often used vasopressor agents in the treatment of vasodilatory shock. However, progressive catecholamine resistance is a feared complication. Recent studies have shown that arginine vasopressin, an endogenous hormone of the neurohypophysis, may be a potent vasopressor when used in combination with catecholamines. During catecholamine-resistant septic and postcardiotomy shock, argine vasopressin results in a significant increase in mean arterial pressure as well as a significant decrease in heart rate and vasopressor requirements. In the guidelines of both the "American Heart Association" and the "International Liaison Committee on Resuscitation" from the year 2000, arginine vasopressin is recommended as a possibly helpful agent in therapy refractory vasodilatory septic shock. There is currently limited data on possible side effects of a continuous arginine vasopressin therapy in vasodilatory shock. Therefore, arginine vasopressin should be restricted to patients where adequate stabilization of hemodynamic function cannot be achieved by conventional vasopressor therapy alone.