Thromboembolic events during continuous vasopressin infusions: a retrospective evaluation
Bruce A Doepker1, Maria R Lucarelli, Amy Lehman
1Department of Pharmacy, The Ohio State University Medical Center, Columbus, OH 43210, USA. bruce.doepker@osumc.edu
The Annals of Pharmacotherapy
|August 9, 2007
Summary
Vasopressin infusions in shock patients did not increase the risk of venous thromboembolism (VTE). This study found no significant difference in VTE incidence between vasopressin and catecholamine groups, suggesting its safety for hemodynamic support.
Area of Science:
- Critical Care Medicine
- Pharmacology
- Thrombosis Research
Background:
- Published guidelines suggest vasopressin for shock treatment, but its clinical safety, particularly regarding thromboembolism, is not well-established.
- Vasopressin's known effects on platelet aggregation and coagulation factors warrant investigation into its thrombotic potential.
Purpose of the Study:
- To compare the incidence of venous thromboembolism (VTE) in patients diagnosed with shock who received vasopressin versus those who did not.
- To evaluate the safety of vasopressin as a hemodynamic support agent in shock patients concerning VTE risk.
Main Methods:
- Retrospective, single-center cohort study of 350 shock patients in an intensive care unit.
- Patients were divided into two groups: those receiving catecholamines only and those receiving vasopressin with or without catecholamines.
- Venous thromboembolism (VTE) occurrence was the primary outcome, defined by Doppler ultrasound, CT, or discharge records. Logistic regression was used for risk factor analysis.
Main Results:
- The crude incidence of VTE was similar between the vasopressin (7.4%) and catecholamine (8%) groups (p = 0.84).
- No significant differences were observed in deep venous thrombosis or pulmonary embolism rates between the groups.
- Adjusted analysis confirmed no statistically significant difference in VTE incidence between vasopressin and catecholamine treatment arms (p = 0.72).
Conclusions:
- This study provides initial evidence that vasopressin infusions do not elevate the risk of VTE in patients experiencing shock.
- Vasopressin appears to be a safe option for hemodynamic support in shock, without a discernible increase in thrombotic events.
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