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>Journals >Medicina Crítica >Year 2003, Issue 1


Carrillo ER, González SJA
Vasopressin in the management of refractary shock with vasodilatation
Rev Asoc Mex Med Crit y Ter Int 2003; 17 (1)

Language: Español
References: 53
Page: 5-18
PDF: 115.14 Kb.


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ABSTRACT

Introduction: Refractary shock with vasodilatation is caused by sepsis, hemorrhagic shock, after cardiopulmonary bypass, milrinone intoxication, organ donors receptors, burned patients and after placement of ventricular assistance dispositive. Inappropiately low levels of vasopressin (VP) which plays an important role in the maintenance of systemic vascular resistance index (SVRI) and mean arterial pressure (MAP) are present.
Patients and methods: Thirteen patients with diagnosis of refractary shock with vasodilatation were included; hemodynamic monitoring, and echocardiography were performed. VP infusion was started at dose of 0.04 IU/min from 24 to 96 hours. The values were registered at 2, 4, 8, 16, and 24 hours.
Results: It was observed during the infusion of VP a significant increase of SVRI and MAP (p ‹ 0.05) without changes in any other parameters. Shock was corrected and it was possible to discontinue norepinephrine and reduce dopamine at dopa dose. Two patients died due to multiple organic failure.
Conclusion: The infusion of small doses of VP in refractory shock with vasodilatation increases the SVRI and perfusion pressure without changes in other hemodynamic and metabolic parameters.


Key words: Refractary shock, treatment, vasopresine, monitoring.


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