Arginine vasopressin and serum nitrite/nitrate concentrations in advanced vasodilatory shock

Acta Anaesthesiologica Scandinavica
M W DünserA J Mayr

Abstract

Arginine-vasopressin (AVP) can successfully stabilize hemodynamics in patients with advanced vasodilatory shock. It has been suggested that inhibition of cytokine-induced nitric oxide production may be an important mechanism underlying AVP-induced vasoconstriction. Therefore, serum concentrations of nitrite/nitrate (NOx), the stable metabolite of nitric oxide, were measured in patients suffering from advanced vasodilatory shock treated with either AVP in combination with norepinephrine (NE) or NE alone. This trial was a separate study arm of a previously published prospective, randomized, controlled study on the effects of AVP in advanced vasodilatory shock. Thirty-eight patients were prospectively randomized to receive a combined infusion of AVP (4 U h(-1)) and NE, or NE infusion alone. Serum NOx concentrations were measured at baseline, 24, and 48 h after randomization. The increase in mean arterial pressure during the first hour after study enrollment was documented in all patients. No difference in NOx concentrations was found between groups throughout the study period. AVP patients demonstrated a significantly greater increase in mean arterial pressure than NE patients (22 +/- 10 vs. 5 +/- 9 mmHg; P < 0.001). The magnitude...Continue Reading

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Citations

Feb 18, 2006·Critical Care Medicine·Marc Leone, Walter A Boyle
Nov 30, 2006·Critical Care Medicine·Lucinda K BarrettLucie H Clapp
Sep 22, 2007·Critical Care Medicine·James A Russell
Apr 30, 2008·Current Opinion in Anaesthesiology·Martin W Dünser, Martin Westphal
Jun 30, 2007·Current Opinion in Critical Care·James A Russell
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Jul 28, 2004·Intensive Care Medicine·Martin W DünserWalter R Hasibeder
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