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Vasopressin in pediatric shock and cardiac arrest

Karen Choong1, Niranjan Kissoon

  • 1Pediatric Critical Care and Neonatology, McMaster Children's Hospital, Hamilton, Ontario, Canada. choongk@mcmaster.ca

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|May 23, 2008
PubMed

Insights

Vasopressin shows promise for treating pediatric shock and cardiac arrest, with observational studies indicating improved blood pressure. However, use in children requires caution due to limited evidence, pending further trials.

Area of Science:

  • Pediatric critical care medicine
  • Pharmacology
  • Cardiovascular physiology

Background:

  • Vasopressin is used in adults for vasodilatory shock and cardiac arrest.
  • Limited data exists on vasopressin's efficacy and safety in pediatric populations.
  • Current pediatric dosing is extrapolated from adult studies.

Purpose of the Study:

  • To review the physiology of vasopressin.
  • To synthesize published literature on vasopressin's role in pediatric shock.
  • To assess the current evidence for vasopressin use in children.

Main Methods:

  • Comprehensive literature search of MEDLINE, EMBASE, and Cochrane Library (1966-2007).
  • Inclusion of studies using terms: vasopressin, terlipressin, and shock in pediatrics.
  • Review of reference lists and ongoing trial registries.

Main Results:

  • Observational studies suggest beneficial effects of low-dose vasopressin in pediatric shock.
  • Reported improvements include enhanced blood pressure and reduced catecholamine dependence.
  • Evidence for vasopressin in pediatric vasodilatory shock and cardiac arrest is currently limited.

Conclusions:

  • Vasopressin presents a potential therapeutic option for pediatric shock and cardiac arrest.
  • Cautious administration is recommended due to limited pediatric experience.
  • Results from a forthcoming randomized controlled trial in children are anticipated.
Abstract

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