Vasopressin in Vasodilatory Shock

Crit Care Clin. 2019 Apr;35(2):247-261. doi: 10.1016/j.ccc.2018.11.004. Epub 2019 Jan 23.

Abstract

Vasodilatory shock is the final common pathway for all forms of severe shock, with sepsis the most common primary etiology and the leading cause of critical illness-related mortality. The pathophysiology of this condition remains incompletely elucidated. Deficiency of the neuropeptide hormone vasopressin seems to play a significant role. The physiology of vasopressin and its interaction with the pathophysiology of vasodilatory shock are described in this review. A brief review of the major randomized controlled trials assessing the efficacy and safety of vasopressin and its analogs in this complex patient cohort is also provided.

Keywords: Antidiuretic hormone; Sepsis; Vasodilatory shock; Vasoplegia; Vasopressin.

Publication types

  • Review

MeSH terms

  • Humans
  • Shock, Septic / diagnosis
  • Shock, Septic / drug therapy*
  • Shock, Septic / physiopathology*
  • Vasoconstrictor Agents / therapeutic use*
  • Vasodilation / drug effects*
  • Vasoplegia / diagnosis
  • Vasoplegia / drug therapy*
  • Vasopressins / therapeutic use*

Substances

  • Vasoconstrictor Agents
  • Vasopressins