Vasopressin: Its current role in anesthetic practice

Indian Journal of Critical Care Medicine, 07/18/2011

Mitra JK et al.– The therapeutic use of vasopressin has become increasingly important in the critical care environment in the management of cranial diabetes insipidus, bleeding abnormalities, esophageal variceal hemorrhage, asystolic cardiac arrest and septic shock. After 10 years of ongoing research, vasopressin has grown to a potential component as a vasopressor agent of the anesthesiologist's armamentarium in the treatment of cardiac arrest and severe shock states.

  • Vasopressin is a potent vasopressor that may be a useful therapeutic agent in the treatment of cardiac arrest, septic and several other shock states and esophageal variceal hemorrhage.
  • Studies indicate that the use of vasopressin during cardiopulmonary resuscitation may improve the survival of patients with asystolic cardiac arrest.
  • Vasopressin deficiency can contribute to refractory shock states associated with sepsis, hypovolemia, cardiogenic shock and cardiac arrest.
  • Low doses of vasopressin can restore vasomotor tone in conditions that are resistant to catecholamines, with preservation of renal blood flow and urine output.
  • It may also be useful in reducing bleeding and mortality associated with esophageal variceal hemorrhage.
  • Terlipressin is a useful vasopressin analog that produces sustained increases in blood pressure in septic patients.

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