Vasopressin in vasodilatory shock: is the heart in danger?

Critical Care : the Official Journal of the Critical Care Forum
Balázs HauserPeter Radermacher

Abstract

In patients with hyperdynamic hemodynamics, infusing arginine vasopressin (AVP) in advanced vasodilatory shock is usually accompanied by a decrease in cardiac output and in visceral organ blood flow. Depending on the infusion rate, this vasoconstriction also reduces coronary blood flow despite an increased coronary perfusion pressure. In a porcine model of transitory myocardial ischemia-induced left ventricular dysfunction, Müller and colleagues now report that the AVP-related coronary vaso-constriction may impede diastolic relaxation while systolic contraction remains unaffected. Although any AVP-induced myocardial ischemia undoubtedly is a crucial safety issue, these findings need to be discussed in the context of the model design, the dosing of AVP as well as the complex direct, afterload-independent and systemic, vasoconstriction-related effects on the heart.

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Feb 29, 2008·The New England Journal of Medicine·James A RussellUNKNOWN VASST Investigators

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Citations

Jul 14, 2009·Critical Care : the Official Journal of the Critical Care Forum·Florian SimonBalázs Hauser
May 21, 2014·The Journal of Pediatrics·Shannon N AckerJason Gien
Aug 27, 2016·BioMed Research International·Katarzyna Szadujkis-SzadurskaMarta Gajdus

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