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The Annals of Pharmacotherapy: Vol. 34, No. 2, pp. 250-254. DOI 10.1345/aph.19066
© 2000 Harvey Whitney Books Company.
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Research Articles

The role of vasopressin in the treatment of vasodilation in shock states

V Rozenfeld and JW Cheng

OBJECTIVE: To review the role of vasopressin in the treatment of vasodilatory shock. DATA SOURCES: A MEDLINE search on published reports (1966-April 1999) was conducted. STUDY SELECTION: English-language studies and case reports were selected and evaluated based on quality of review of vasopressin in the treatment of vasodilatory shock. DATA SYNTHESIS: In patients with end-stage vasodilatory shock, baroreceptor reflex is impaired and vasopressin stores are depleted. Persistent elevation of catecholamines may lead to down-regulation of beta-adrenergic receptors and reduces smooth-muscle response to catecholamines, leading to inability of maintaining organ perfusion. Small-scale studies and case reports have demonstrated vasopressin's efficacy in maintaining blood pressure in patients with septic shock, cardiac arrest, and end-stage heart failure, refractory to other vasopressor therapies. CONCLUSIONS: Vasopressin may be a reasonable alternative for patients in vasodilatory shock. However, larger-scale controlled dinical trials are warranted before its routine use can be recommended.


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