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ASA: Vasopressin Reduces Catecholamine Requirements in Patients with Septic Shock By Anne Jacobson Special to DG News ORLANDO, FL -- October 16, 2002 -- Low-dose vasopressin (VP) stabilises arterial pressure and reduces catecholamine requirements among patients treated for septic shock, according to new research. "This regimen works very well in our septic patients," said Rangraj S. Setlur, MD, of the University of Iowa Hospitals and Clinics in Iowa City, United States. Dr. Setlur reported his findings here October 15 at the 55th Annual Meeting of the American Society of Anesthesiologists (ASA). To evaluate the hemodynamic effects of vasopressin therapy in patients requiring treatment for septic shock, Dr. Setlur reviewed the records of eight patients who met the Society of Critical Care Medicine criteria for septic shock and who received a constant VP infusion during treatment. Dr. Setlur evaluated the hemodynamic responses to VP and corresponding changes in catecholamine infusion rates. During the first three hours of therapy, VP was associated with a significant increase in mean arterial pressure, with a mean increase of 19 percent (p<0.05). Overall, 75 percent of patients achieved a clinically acceptable target mean arterial pressure at VP rates less than 0.08 U/min , an effect that was maintained over a 24-hour period. Catecholamine infusion rates were decreased by 50 percent within a three-hour period of VP initiation in five of eight patients (62.5 percent). The requirements of norepinephrine, the most frequently used catecholamine, were decreased by 0.37 µg/kg/min (p<0.05). The mean score on the Acute Physiology And Chronic Health Evaluation for all patients was 23. During the course of treatment, cardiac index, stroke index, and urinary output showed no significant change. VP deficiency has been implicated in the severe vasodilation seen in septic shock. Catecholamine infusions are commonly used to maintain hemodynamic goals. Supplemental low-dose VP, it appears, helps to reduce the requirements for catecholamine in these patients, Dr. Setlur explained. "So far these results are very encouraging," Dr. Setlur said. E-mail this page to a friend or colleague! To print, use this version