Saturday December 10, 2005
Vasopressin .07 units/min ?

There has been a lot of enthusiasm about using vasopressin as vasopressor earlier than later in septic shock patients due to initial encouraging literature with dose of .01-.04 units/min. But anecdotally it has been tried upto .07 units/min to enhance the effect. We looked into the literature in this regard and found atleast one study where dose beyond .04 units/min was reported to be associated with higher adverse effects. Study from Vancouver, Canada looked into 50 patients with mean APACHE II score of 27. Baseline data at 0 hour was compared to 4, 24 and 48 hours of vasopressin infusion. Though most parameters improved there were six cardiac arrests; all but one occurred at a vasopressin dose of 0.05 units/min or more. The final conclusion was "Doses higher than 0.04 units/min were not associated with increased effectiveness and may have been associated with higher adverse effects."


References:

The effects of vasopressin on hemodynamics and renal function in severe septic shock: a case series - Intensive Care Med 2001 Aug;27(8):1416-21