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The Effect of Vasopressin on Gastric Perfusion in Catecholamine‐Dependent Patients in Septic Shock
Author(s) -
van Haren FMP,
Rozendaal FW,
van der Hoeven JG
Publication year - 2004
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0115426504019005532
Subject(s) - medicine , vasopressin , septic shock , anesthesia , perfusion , cardiac index , mean arterial pressure , norepinephrine , shock (circulatory) , blood pressure , splanchnic , splanchnic circulation , cardiac output , hemodynamics , cardiology , heart rate , sepsis , dopamine
Objectives : To study the effect of continuous infusion of vasopressin on the splanchnic circulation in patients with severe septic shock. Methods: Prospective clinical study. ICU in a teaching hospital. Eleven consecutive patients with documented septic shock who remained hypotensive despite norepinephrine infusion at a rate ≥0.2μ g/kg/min. Insertion of a gastric tonometry catheter, and continuous infusion of vasopressin 0.04 units/min during 4 hours. Results: Difference between gastric and arterial CO 2 partial pressure (P[g‐a]CO 2 gap), mean arterial pressure, and cardiac index were recorded at baseline and after 15 minutes, 30 minutes, 60 minutes, 120 minutes, and 240 minutes. The median P[g‐a]CO 2 gap increased from 5 mm Hg at baseline to 19 mm Hg after 4 hours ( p = .022). Mean arterial pressure increased from 61 ± 13 mm Hg at baseline to 68 ± 9mm Hg after 4 hours ( p = .055). No significant changes in cardiac index were noted. Conclusions: In norepinephrine‐dependent patients in septic shock, continuous infusion of low‐dose vasopressin results in a significant increase of the P[g‐a]CO 2 gap compatible with gastrointestinal hypoperfusion.