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Intensive Care Medicine

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01-07-2008 | Pediatric Original

Clinical impact of vasopressin infusion on hemodynamics, liver and renal function in pediatric patients

Authors: Nameet Jerath, Helena Frndova, Brian W. McCrindle, Rebecca Gurofsky, Tilman Humpl

Published in: Intensive Care Medicine | Issue 7/2008

Abstract

Objective

To study effects of vasopressin on hemodynamic, clinical, and laboratory variables in children with advanced vasodilatory shock.

Design and setting

Retrospective study in a multidisciplinary tertiary pediatric critical care unit.

Patients and participants

Patients (n = 117; 32 noncardiac, 85 postcardiac surgery) requiring intravenous vasopressin infusion longer than 60 min for advanced shock (January 2004 to December 2005).

Interventions

Vasopressin infusion (n = 157).

Measurements and results

Both cardiac and noncardiac patients showed a significant decrease in inotrope requirement without change in central venous saturation or lactate during infusion. Both groups had increased urea and creatinine and decreased urine output with longer duration/higher cumulative dose of vasopressin. There was a significant increase in conjugated bilirubin level in the noncardiac group during vasopressin infusion; noncardiac patients showed higher AST levels with higher cumulative dose or longer duration of infusion. Postcardiac surgical patients showed a trend towards normal INR values which persisted after vasopressin infusion. Platelet counts were significantly lower during infusion in both groups.

Conclusions

Vasopressin infusion improved the hemodynamic state in advanced shock without compromising cardiac function. Urine output and creatinine levels were adversely affected but were reversible. This effect was more pronounced with higher dose or duration of infusion. There was no major effect on liver function but a significant reduction in platelet counts. These data suggest that vasopressin is useful in states of vasodilatory shock with limitations regarding to its adverse renal effects and on platelet counts.

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Title: Clinical impact of vasopressin infusion on hemodynamics, liver and renal function in pediatric patients
Authors: Nameet Jerath
Helena Frndova
Brian W. McCrindle
Rebecca Gurofsky
Tilman Humpl
Publication date: 01-07-2008
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 7/2008
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1055-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Clinical impact of vasopressin infusion on hemodynamics, liver and renal function in pediatric patients

Abstract

Objective

Design and setting

Patients and participants

Interventions

Measurements and results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Design and setting

Patients and participants

Interventions

Measurements and results

Conclusions

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