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World Journal of Surgery
Published in: World Journal of Surgery 2/2011

01-02-2011

Impact of Low-dose Vasopressin on Trauma Outcome: Prospective Randomized Study

Authors: Stephen M. Cohn, Janet McCarthy, Ronald M. Stewart, Rachelle B. Jonas, Daniel L. Dent, Joel E. Michalek

Published in: World Journal of Surgery | Issue 2/2011

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Abstract

Background

We previously found that regardless of the animal injury model used resuscitation strategies that minimize fluid administration requirements lead to better outcomes. We hypothesized that a resuscitation regimen that limited the total volume of fluid administered would reduce morbidity and mortality rates in critically ill trauma patients.

Methods

We performed a double-blind randomized trial to assess the safety and efficacy of adding vasopressin to resuscitative fluid. Subjects were hypotensive adults who had sustained acute traumatic injury. Subjects were given fluid alone (control group) or fluid plus vasopressin (experimental group), first as a bolus (4 IU) and then as an intravenous infusion of 200 ml/h (vasopressin 2.4 IU/h) for 5 h.

Results

We randomly assigned 78 patients to the experimental group (n = 38) or the control group (n = 40). The groups were similar in age, sex, preexisting medical illnesses, and mechanism and severity of injury. Serum vasopressin concentrations were higher in the experimental group than in the control group at admission, after infusion of vasopressin (p = 0.01), and 12 h later. The experimental group required a significantly lower total volume of resuscitation fluid over 5 days than did the control group (p = 0.04). The mortality rate at 5 days was 13% in the experimental group and 25% in the control group (p = 0.19). The rates of adverse events, organ dysfunction, and 30-day mortality were similar.

Conclusions

This is the first trial to investigate the impact of vasopressin administration in trauma patients. Infusion of low-dose vasopressin maintained elevated serum vasopressin levels and decreased fluid requirements after injury.
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Metadata
Title
Impact of Low-dose Vasopressin on Trauma Outcome: Prospective Randomized Study
Authors
Stephen M. Cohn
Janet McCarthy
Ronald M. Stewart
Rachelle B. Jonas
Daniel L. Dent
Joel E. Michalek
Publication date
01-02-2011
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 2/2011
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-010-0875-8

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