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Arginine vasopressin in advanced vasodilatory shock: a prospective, randomized, controlled study
Martin W Dünser1, Andreas J Mayr, Hanno Ulmer
1Division of General and Surgical Intensive Care Medicine, Department of Anesthesia and Critical Care Medicine, The Leopold Franzens University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
Circulation
|May 7, 2003
Summary
Arginine vasopressin (AVP) combined with norepinephrine (NE) improved cardiocirculatory function in patients with severe vasodilatory shock resistant to catecholamines. This combination therapy demonstrated superior outcomes compared to NE alone.
Area of Science:
- Critical care medicine
- Cardiovascular physiology
- Pharmacology
Background:
- Vasodilatory shock is a life-threatening condition in critically ill patients.
- Catecholamines are standard vasopressors, but resistance can occur.
- Arginine vasopressin (AVP) shows promise as an alternative vasopressor.
Purpose of the Study:
- To evaluate the efficacy of combined AVP and norepinephrine (NE) versus NE alone.
- To assess treatment effects in patients with catecholamine-resistant vasodilatory shock.
Main Methods:
- Prospective randomized trial of 48 patients.
- Comparison of AVP + NE infusion versus NE infusion alone.
- Hemodynamic, acid-base, organ function, and gastric tonometry variables were measured.
Main Results:
- AVP + NE group showed lower heart rate, NE requirements, and tachyarrhythmias.
- Mean arterial pressure and cardiac indices were significantly higher with AVP + NE.
- Gastrointestinal perfusion was better preserved in the AVP + NE group.
Conclusions:
- Combined AVP and NE infusion is superior to NE alone.
- This combination effectively treats cardiocirculatory failure in catecholamine-resistant shock.
