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Critical Care
Published in: Critical Care 6/2006

01-12-2006 | Commentary

Vasopressin in vasodilatory shock: ensure organ blood flow, but take care of the heart!

Authors: Martin W Dünser, Walter R Hasibeder

Published in: Critical Care | Issue 6/2006

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Abstract

Supplementary arginine vasopressin infusion in advanced vasodilatory shock may be accompanied by a decrease in cardiac index and systemic oxygen transport capacity in approximately 40% of patients. While a reduction of cardiac output most frequently occurs in patients with hyperdynamic circulation, it is less often observed in patients with low cardiac index. Infusion of inotropes, such as dobutamine, may be an effective strategy to restore systemic blood flow. However, when administering inotropic drugs, systemic blood flow should be increased to adequately meet systemic demands (assessed by central or mixed venous oxygen saturation) without putting an excessive beta-adrenergic stress on the heart. Overcorrection of cardiac index to hyperdynamic values with inotropes places myocardial oxygen supply at significant risk.
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Metadata
Title
Vasopressin in vasodilatory shock: ensure organ blood flow, but take care of the heart!
Authors
Martin W Dünser
Walter R Hasibeder
Publication date
01-12-2006
Publisher
BioMed Central
Published in
Critical Care / Issue 6/2006
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc5089

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