Critical Care

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Commentary

Dear vasopressin, where is your place in septic shock?

Martin W Duenser1* and Walter R Hasibeder2

Author Affiliations

1 Resident, Division of General and Surgical Intensive Care Medicine, Department of Anesthesiology and Critical Care Medicine, The Medical University of Innsbruck, Austria

2 Head, Department of Anesthesiology and Critical Care Medicine, Krankenhaus der Barmherzigen Schwestern, Ried im Innkreis, Austria

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Critical Care 2005, 9:134-135 doi:10.1186/cc2996

Published: 15 November 2004

Abstract

Cardiovascular failure is one of the central therapeutic problems in patients with severe infection. Although norepinephrine is a potent and, in most cases, highly effective vasopressor agent, very high dosages leading to significant side effects can be necessary to stabilize advanced shock. As a supplementary vasopressor, arginine vasopressin can reverse hemodynamic failure and significantly decrease norepinephrine dosages. Whether the promising possibility of 'bridging' advanced septic shock when the benefit/risk ratio of catecholamine therapy leaves a clinically tolerable range may improve quantitative and qualitative patient outcome can only be determined by a large, prospective, randomized study.

Keywords:
arginine vasopressin; hormone replacement; hypotension; norepinephrine; septic shock