The Effects of Vasopressin on Systemic Hemodynamics in Catecholamine-Resistant Septic and Postcardiotomy Shock: A Retrospective Analysis
We retrospectively investigated the effects of continuous arginine vasopressin (AVP) infusion on systemic hemodynamics, acid/base status, and laboratory variables in patients (mean age [mean ± sd]= 66.3 ± 10.1 yr) with catecholamine-resistant septic (n = 35) or postcardiotomy shock (n = 25). Hemodyn...
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| Veröffentlicht in: | Anesthesia and analgesia 2001-07, Vol.93 (1), p.7-13 |
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| creator | Dünser, Martin W. Mayr, Andreas J. Ulmer, Hanno Ritsch, Nicole Knotzer, Hans Pajk, Werner Luckner, Günther Mutz, Norbert J. Hasibeder, Walter R. |
| description | We retrospectively investigated the effects of continuous arginine vasopressin (AVP) infusion on systemic hemodynamics, acid/base status, and laboratory variables in patients (mean age [mean ± sd]= 66.3 ± 10.1 yr) with catecholamine-resistant septic (n = 35) or postcardiotomy shock (n = 25). Hemodynamic and acid/base data were obtained before; 30 min after; and 1, 4, 12, 24, 48, and 72 h after the start of AVP infusion. Laboratory examinations were recorded before and 24, 48, and 72 h after the start of AVP infusion. For statistical analysis, a mixed-effects model was used. The overall intensive care unit mortality was 66.7%. AVP administration caused a significant increase in mean arterial pressure (+29%) and systemic vascular resistance (+56%), accompanied by a significant decrease in heart rate (−24%) and mean pulmonary arterial pressure (−11%) without any change in stroke volume index. Norepinephrine requirements could be reduced by 72% within 72 h. During AVP infusion, a significant increase in liver enzymes and total bilirubin concentration and a significant decrease in platelet count occurred. Arginine vasopressin was effective in reversing systemic hypotension. However, adverse effects on gastrointestinal perfusion and coagulation cannot be excluded. |
| doi_str_mv | 10.1097/00000539-200107000-00003 |
| format | Article |
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Hemodynamic and acid/base data were obtained before; 30 min after; and 1, 4, 12, 24, 48, and 72 h after the start of AVP infusion. Laboratory examinations were recorded before and 24, 48, and 72 h after the start of AVP infusion. For statistical analysis, a mixed-effects model was used. The overall intensive care unit mortality was 66.7%. AVP administration caused a significant increase in mean arterial pressure (+29%) and systemic vascular resistance (+56%), accompanied by a significant decrease in heart rate (−24%) and mean pulmonary arterial pressure (−11%) without any change in stroke volume index. Norepinephrine requirements could be reduced by 72% within 72 h. During AVP infusion, a significant increase in liver enzymes and total bilirubin concentration and a significant decrease in platelet count occurred. Arginine vasopressin was effective in reversing systemic hypotension. However, adverse effects on gastrointestinal perfusion and coagulation cannot be excluded.</description><identifier>ISSN: 0003-2999</identifier><identifier>EISSN: 1526-7598</identifier><identifier>DOI: 10.1097/00000539-200107000-00003</identifier><identifier>PMID: 11429329</identifier><identifier>CODEN: AACRAT</identifier><language>eng</language><publisher>Hagerstown, MD: International Anesthesia Research Society</publisher><subject>Acid-Base Equilibrium - drug effects ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiac Surgical Procedures - adverse effects ; Catecholamines - therapeutic use ; Critical Care ; Drug Resistance ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. 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Hemodynamic and acid/base data were obtained before; 30 min after; and 1, 4, 12, 24, 48, and 72 h after the start of AVP infusion. Laboratory examinations were recorded before and 24, 48, and 72 h after the start of AVP infusion. For statistical analysis, a mixed-effects model was used. The overall intensive care unit mortality was 66.7%. AVP administration caused a significant increase in mean arterial pressure (+29%) and systemic vascular resistance (+56%), accompanied by a significant decrease in heart rate (−24%) and mean pulmonary arterial pressure (−11%) without any change in stroke volume index. Norepinephrine requirements could be reduced by 72% within 72 h. During AVP infusion, a significant increase in liver enzymes and total bilirubin concentration and a significant decrease in platelet count occurred. Arginine vasopressin was effective in reversing systemic hypotension. However, adverse effects on gastrointestinal perfusion and coagulation cannot be excluded.</description><subject>Acid-Base Equilibrium - drug effects</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Catecholamines - therapeutic use</subject><subject>Critical Care</subject><subject>Drug Resistance</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Emergency and intensive care: infection, septic shock</subject><subject>Female</subject><subject>Hemodynamics - drug effects</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Models, Biological</subject><subject>Norepinephrine - therapeutic use</subject><subject>Postoperative Complications - drug therapy</subject><subject>Postoperative Complications - physiopathology</subject><subject>Retrospective Studies</subject><subject>Shock - drug therapy</subject><subject>Shock - physiopathology</subject><subject>Shock, Septic - drug therapy</subject><subject>Shock, Septic - physiopathology</subject><subject>Stroke Volume - drug effects</subject><subject>Survivors</subject><subject>Vasoconstrictor Agents - therapeutic use</subject><subject>Vasopressins - therapeutic use</subject><issn>0003-2999</issn><issn>1526-7598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kttu1DAQhi0EokvhFZAvEHcpPuRk7larQpEqgbqFW8txJkqoEwePt1XegMeuwy6HG3xj-_f3z9gzJoRydsGZqt6xdRRSZYIxzqq0yVZFPiEbXogyqwpVPyWbVcqEUuqMvED8zla4Lp-TM85zoaRQG_Lztgd62XVgI1Lf0W8G_RwAcZion-h-wQjjYOkVjL5dJpPWSNPZzkSwvXdJmCC7ARwwminSPcwx4WZq6ReP0ZrQDj76caH73tu793RLbyAGj3PKONwD3U7GLcn9kjzrjEN4dZrPydcPl7e7q-z688dPu-11ZguZXgNClJ2ohWqsaaHMQbK2yQVTTSXqtrC5qlTdVEZB03ClDJdtkYgEt0rJspDn5O0x7hz8jwNg1OOAFpwzE_gD6irVl4maJbA-gjbdFgN0eg7DaMKiOdNrF_TvLug_XfglyWR9fcpxaEZo_xpPZU_AmxNg0BrXBTPZAf9JULCai4TlR-zBuwgB79zhAYLuwbjY6_99AvkI7_ag6Q</recordid><startdate>20010701</startdate><enddate>20010701</enddate><creator>Dünser, Martin W.</creator><creator>Mayr, Andreas J.</creator><creator>Ulmer, Hanno</creator><creator>Ritsch, Nicole</creator><creator>Knotzer, Hans</creator><creator>Pajk, Werner</creator><creator>Luckner, Günther</creator><creator>Mutz, Norbert J.</creator><creator>Hasibeder, Walter R.</creator><general>International Anesthesia Research Society</general><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20010701</creationdate><title>The Effects of Vasopressin on Systemic Hemodynamics in Catecholamine-Resistant Septic and Postcardiotomy Shock: A Retrospective Analysis</title><author>Dünser, Martin W. ; Mayr, Andreas J. ; Ulmer, Hanno ; Ritsch, Nicole ; Knotzer, Hans ; Pajk, Werner ; Luckner, Günther ; Mutz, Norbert J. ; Hasibeder, Walter R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5303-e226f2829bcade64e30db4209b728d5c49798b7a9ebb199a13d50dbcadd993653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Acid-Base Equilibrium - drug effects</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Catecholamines - therapeutic use</topic><topic>Critical Care</topic><topic>Drug Resistance</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Emergency and intensive care: infection, septic shock</topic><topic>Female</topic><topic>Hemodynamics - drug effects</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Models, Biological</topic><topic>Norepinephrine - therapeutic use</topic><topic>Postoperative Complications - drug therapy</topic><topic>Postoperative Complications - physiopathology</topic><topic>Retrospective Studies</topic><topic>Shock - drug therapy</topic><topic>Shock - physiopathology</topic><topic>Shock, Septic - drug therapy</topic><topic>Shock, Septic - physiopathology</topic><topic>Stroke Volume - drug effects</topic><topic>Survivors</topic><topic>Vasoconstrictor Agents - therapeutic use</topic><topic>Vasopressins - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dünser, Martin W.</creatorcontrib><creatorcontrib>Mayr, Andreas J.</creatorcontrib><creatorcontrib>Ulmer, Hanno</creatorcontrib><creatorcontrib>Ritsch, Nicole</creatorcontrib><creatorcontrib>Knotzer, Hans</creatorcontrib><creatorcontrib>Pajk, Werner</creatorcontrib><creatorcontrib>Luckner, Günther</creatorcontrib><creatorcontrib>Mutz, Norbert J.</creatorcontrib><creatorcontrib>Hasibeder, Walter R.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Anesthesia and analgesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dünser, Martin W.</au><au>Mayr, Andreas J.</au><au>Ulmer, Hanno</au><au>Ritsch, Nicole</au><au>Knotzer, Hans</au><au>Pajk, Werner</au><au>Luckner, Günther</au><au>Mutz, Norbert J.</au><au>Hasibeder, Walter R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effects of Vasopressin on Systemic Hemodynamics in Catecholamine-Resistant Septic and Postcardiotomy Shock: A Retrospective Analysis</atitle><jtitle>Anesthesia and analgesia</jtitle><addtitle>Anesth Analg</addtitle><date>2001-07-01</date><risdate>2001</risdate><volume>93</volume><issue>1</issue><spage>7</spage><epage>13</epage><pages>7-13</pages><issn>0003-2999</issn><eissn>1526-7598</eissn><coden>AACRAT</coden><abstract>We retrospectively investigated the effects of continuous arginine vasopressin (AVP) infusion on systemic hemodynamics, acid/base status, and laboratory variables in patients (mean age [mean ± sd]= 66.3 ± 10.1 yr) with catecholamine-resistant septic (n = 35) or postcardiotomy shock (n = 25). Hemodynamic and acid/base data were obtained before; 30 min after; and 1, 4, 12, 24, 48, and 72 h after the start of AVP infusion. Laboratory examinations were recorded before and 24, 48, and 72 h after the start of AVP infusion. For statistical analysis, a mixed-effects model was used. The overall intensive care unit mortality was 66.7%. AVP administration caused a significant increase in mean arterial pressure (+29%) and systemic vascular resistance (+56%), accompanied by a significant decrease in heart rate (−24%) and mean pulmonary arterial pressure (−11%) without any change in stroke volume index. Norepinephrine requirements could be reduced by 72% within 72 h. During AVP infusion, a significant increase in liver enzymes and total bilirubin concentration and a significant decrease in platelet count occurred. Arginine vasopressin was effective in reversing systemic hypotension. However, adverse effects on gastrointestinal perfusion and coagulation cannot be excluded.</abstract><cop>Hagerstown, MD</cop><pub>International Anesthesia Research Society</pub><pmid>11429329</pmid><doi>10.1097/00000539-200107000-00003</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acid-Base Equilibrium - drug effects Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cardiac Surgical Procedures - adverse effects Catecholamines - therapeutic use Critical Care Drug Resistance Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Emergency and intensive care: infection, septic shock Female Hemodynamics - drug effects Humans Intensive care medicine Male Medical sciences Models, Biological Norepinephrine - therapeutic use Postoperative Complications - drug therapy Postoperative Complications - physiopathology Retrospective Studies Shock - drug therapy Shock - physiopathology Shock, Septic - drug therapy Shock, Septic - physiopathology Stroke Volume - drug effects Survivors Vasoconstrictor Agents - therapeutic use Vasopressins - therapeutic use |
| title | The Effects of Vasopressin on Systemic Hemodynamics in Catecholamine-Resistant Septic and Postcardiotomy Shock: A Retrospective Analysis |
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