ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
David N. Helman
Mathew R. Williams
Yoshifumi Naka
Mehmet C. Oz
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Morales, D. L.S.
Right arrow Articles by Oz, M. C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Morales, D. L.S.
Right arrow Articles by Oz, M. C.

Ann Thorac Surg 2000;69:102-106
© 2000 The Society of Thoracic Surgeons

Original Articles

Arginine vasopressin in the treatment of 50 patients with postcardiotomy vasodilatory shock

David L.S. Morales, MDa, David Gregg, BAa, David N. Helman, MDa, Mathew R. Williams, MDa, Yoshifumi Naka, MD, PhDa, Donald W. Landry, MDb, Mehmet C. Oz, MDa

a Department of Surgery, Columbia University College of Physicians & Surgeons, New York, New York, USA
b Department of Medicine, Columbia University College of Physicians & Surgeons, New York, New York, USA

Address reprint requests to Dr Morales, Department of Cardiothoracic Surgery, Columbia University College of Physicians & Surgeons, MHB 7-435, 177 Fort Washington, New York, NY 10032
e-mail: dlm36{at}columbia.edu

Background. The barroreflex-mediated secretion of arginine vasopressin has been found to be defective in a variety of vasodilatory shock states, such as postcardiotomy shock, and administration of the hormone markedly improves vasomotor tone and blood pressure. The high incidence of vasodilatory shock in patients undergoing left ventricular assist device (LVAD) implantation makes this population an ideal model in which to assess the risks and benefits of vasopressin.

Methods. The medical records of the 102 patients receiving LVADs at Columbia-Presbyterian Medical Center from January 1995 to August 1998 were reviewed. Fifty patients were eligible for study based on a history of arginine vasopressin administration in the operating room or intensive care unit within 24 hours of implantation.

Results. Despite LVAD implantation and the administration of vasopressors, patients were hypotensive with a mean arterial pressure less than 60 mm Hg. The administration of vasopressin (0.09 ± 0.05 U/min) increased mean arterial pressure (58 ± 13 to 75 ± 14 mm Hg; p < 0.001) while reducing norepinephrine administration (11.7 ± 13 to 7.9 ± 6.0 mcg/min; p = 0.023). There was no significant change in LVAD flow. The incidence of compromised regional perfusion was not different between LVAD patients who received vasopressin as compared to hemodynamically stable LVAD patients who did not receive vasopressin.

Conclusions. We have demonstrated vasopressin at low doses to be a safe and an effective vasopressor in 50 patients with postcardiotomy vasodilatory shock.




This article has been cited by other articles:


Home page
 Br J AnaesthHome page
N. Mongardon, A. Dyson, and M. Singer
Pharmacological optimization of tissue perfusion
Br. J. Anaesth., July 1, 2009; 103(1): 82 - 88.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
J. A. Russell, K. R. Walley, J. Singer, A. C. Gordon, P. C. Hebert, D. J. Cooper, C. L. Holmes, S. Mehta, J. T. Granton, M. M. Storms, et al.
Vasopressin versus Norepinephrine Infusion in Patients with Septic Shock
N. Engl. J. Med., February 28, 2008; 358(9): 877 - 887.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
N. M. Katz
The emerging specialty of cardiothoracic surgical critical care: the leadership role of cardiothoracic surgeons on the multidisciplinary team.
J. Thorac. Cardiovasc. Surg., November 1, 2007; 134(5): 1109 - 1111.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. Egi, R. Bellomo, C. Langenberg, M. Haase, A. Haase, L. Doolan, G. Matalanis, S. Seevenayagam, and B. Buxton
Selecting a Vasopressor Drug for Vasoplegic Shock After Adult Cardiac Surgery: A Systematic Literature Review
Ann. Thorac. Surg., February 1, 2007; 83(2): 715 - 723.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Heart Circ. Physiol.Home page
H. Knotzer, W. Pajk, S. Maier, R. Ladurner, A. Kleinsasser, V. Wenzel, M. W. Dunser, H. Ulmer, and W. R. Hasibeder
Arginine vasopressin reduces intestinal oxygen supply and mucosal tissue oxygen tension
Am J Physiol Heart Circ Physiol, July 1, 2005; 289(1): H168 - H173.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. A. Scheurer, S. M. Bradley, and A. M. Atz
Vasopressin to attenuate pulmonary hypertension and improve systemic blood pressure after correction of obstructed total anomalous pulmonary venous return
J. Thorac. Cardiovasc. Surg., February 1, 2005; 129(2): 464 - 466.
[Full Text] [PDF]

Home page
 J Intensive Care MedHome page
P. C. Dyke II and J. D. Tobias
Vasopressin: Applications in Clinical Practice
J Intensive Care Med, July 1, 2004; 19(4): 220 - 228.
[Abstract] [PDF]

Home page
 Anesth. Analg.Home page
N. A. Nussmeier, C. B. Probert, D. Hirsch, J. R. Cooper Jr., I. D. Gregoric, T. J. Myers, and O. H. Frazier
Anesthetic Management for Implantation of the Jarvik 2000TM Left Ventricular Assist System
Anesth. Analg., October 1, 2003; 97(4): 964 - 971.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
J. A. Guzman, A. E. Rosado, and J. A. Kruse
Vasopressin vs. norepinephrine in endotoxic shock: systemic, renal, and splanchnic hemodynamic and oxygen transport effects
J Appl Physiol, August 1, 2003; 95(2): 803 - 809.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. L.S. Morales, M. J. Garrido, J. D. Madigan, D. N. Helman, J. Faber, M. R. Williams, D. W. Landry, and M. C. Oz
A double-blind randomized trial: prophylactic vasopressin reduces hypotension after cardiopulmonary bypass
Ann. Thorac. Surg., March 1, 2003; 75(3): 926 - 930.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
W. J. Gomes, M. R. Erlichman, M. L. Batista-Filho, M. Knobel, D. R. Almeida, A. C. Carvalho, R. Catani, and E. Buffolo
Vasoplegic syndrome after off-pump coronary artery bypass surgery
Eur. J. Cardiothorac. Surg., February 1, 2003; 23(2): 165 - 169.
[Abstract] [Full Text] [PDF]

Home page
 Am J Crit CareHome page
T. N. Albright, M. A. Zimmerman, and C. H. Selzman
Vasopressin in the Cardiac Surgery Intensive Care Unit
Am. J. Crit. Care., July 1, 2002; 11(4): 326 - 330.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
K. Meersschaert, L. Brun, M. Gourdin, S. Mouren, M. Bertrand, B. Riou, and P. Coriat
Terlipressin-Ephedrine Versus Ephedrine to Treat Hypotension at the Induction of Anesthesia in Patients Chronically Treated with Angiotensin Converting-Enzyme Inhibitors: A Prospective, Randomized, Double-Blinded, Crossover Study
Anesth. Analg., April 1, 2002; 94(4): 835 - 840.
[Abstract] [Full Text] [PDF]

Home page
 SEMIN CARDIOTHORAC VASC ANESTHHome page
K. A. Thielmeier, J. R. Pank, R. D. Dowling, and L. A. Gray JR
Anesthetic and Perioperative Considerations in Patients Undergoing Placement of Totally Implantable Replacement Hearts
Seminars in Cardiothoracic and Vascular Anesthesia, November 1, 2001; 5(4): 335 - 344.
[Abstract] [PDF]

Home page
 ChestHome page
C. L. Holmes, B. M. Patel, J. A. Russell, and K. R. Walley
Physiology of Vasopressin Relevant to Management of Septic Shock
Chest, September 1, 2001; 120(3): 989 - 1002.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
M. W. Dunser, A. J. Mayr, H. Ulmer, N. Ritsch, H. Knotzer, W. Pajk, G. Luckner, N. J. Mutz, and W. R. Hasibeder
The Effects of Vasopressin on Systemic Hemodynamics in Catecholamine-Resistant Septic and Postcardiotomy Shock: A Retrospective Analysis
Anesth. Analg., July 1, 2001; 93(1): 7 - 13.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2000 by The Society of Thoracic Surgeons.