Arginine vasopressin in septic shock: supplement or substitute for norepinephrine?

Abstract

In the current issue of Critical Care, Simon and coworkers investigated the effects of first-line arginine vasopressin (AVP) on organ function and systemic metabolism compared with norepinephrine in a pig model of fecal peritonitis. AVP was titrated according to the mean arterial pressure suggesting a vasopressor rather than a hormone replacement therapy. The study provides some evidence for the safety of this therapeutic approach. It needs to be determined whether AVP is most beneficial as a constant low-dose infusion to supplement norepinephrine or in higher doses than currently recommended to substitute norepinephrine. In addition, future studies are warranted to evaluate whether a first-line therapy of AVP is superior to a last-resort administration.

• Authors: Sebastian Rehberg, Perenlei Enkhbaatar, Daniel L Traber
• Journal: Critical care (London, England) (Crit Care) Vol. 13 Issue 4 Pg. 178 ( 2009) ISSN: 1466-609X [Electronic] England
• PMID: 19691818 (Publication Type: Comment, Journal Article)

Chemical References

• Vasoconstrictor Agents
• Arginine Vasopressin
• Norepinephrine

Topics

• Animals
• Arginine Vasopressin (administration & dosage, pharmacology, therapeutic use)
• Drug-Related Side Effects and Adverse Reactions
• Norepinephrine (therapeutic use)
• Shock, Septic (drug therapy)
• Sus scrofa
• Vasoconstrictor Agents (administration & dosage, pharmacology, therapeutic use)