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

Dünser, Martin W; Hasibeder, Walter R (2006). Vasopressin in vasodilatory shock: ensure organ blood flow, but take care of the heart! Critical care, 10(6), p. 172. London: BioMed Central 10.1186/cc5089

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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.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Dünser, Martin Wolfgang

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1364-8535

ISBN:

17129364

Publisher:

BioMed Central

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:48

Last Modified:

06 Dec 2014 16:49

Publisher DOI:

10.1186/cc5089

PubMed ID:

17129364

Web of Science ID:

000247718500030

BORIS DOI:

10.7892/boris.19953

URI:

https://boris.unibe.ch/id/eprint/19953 (FactScience: 3031)

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