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Vasopressin in haemorrhagic shock - Vasopressin vs Fluid

IVAN HRONEK ih7 at msn.com
Sat Jul 28 17:14:00 BST 2007 

Vasopressin during uncontrolled hemorrhagic shock: less bleeding below the diaphragm, more perfusion above.Stadlbauer KH - Anesth Analg - 01-SEP-2005; 101(3): 830-2Vasopressin in hemorrhagic shock.Sharma RM - Anesth Analg - 01-SEP-2005; 101(3): 833-4, table of contentsWe describe the treatment of two patients with hemorrhagic shock unresponsive to volume replacement and catecholamines. Both patients responded to a small-dose infusion of vasopressin, which allowed tapering off of the catecholamines. The possible role of small-dose infusions of vasopressin in fluid- and catecholamine-resistant hemorrhagic shock is discussed. Should the patients be kept (after the initial phase) vasodilated with borderline pressure, or vasoconstricted (vasopressin) with borderline pressure ?This would decrease the amount of crystalloids that we overuse so much..and in this respect, how about Ketamine instead of Fentanyl ?Ivan Hronek MDChief, Critical Care & Trauma AnesthesiaSFMC Gas, Inc.St. Francis Medical Center3630 E. Imperial HighwayLynwood, CA 90262 Cell: 310 487-3288Pager: 310 636-6020

> Date: Tue, 24 Jul 2007 06:48:53 +0200> From: jacob.scholz at gmail.com> To: trauma-list at trauma.org> Subject: Vasopressin in haemorrhagic shock - Vasopressin vs Fluid> > After having read the thread about massive transfusion protocols I received> an e-mail with the following article:> > Vasopressin improves survival in a porcine model of abdominal vascular> injury> Critical Care 2007, 11:R81 doi:10.1186/cc59772007, 11:R81 doi:10.1186/cc5977> The authors conclude:> "Vasopressin, but not fluid resuscitation or saline placebo, ensured> short-term survival in this vascular injury model with uncontrolled> haemorrhagic shock in sedated pigs."> > They were pigs and they were not transfused, but what does the list think> about vasopressin, maybe in conjunction with transfusion, in human> haemorrhagic shock?> > Jacob> --> trauma-list : TRAUMA.ORG> To change your settings or unsubscribe visit:> http://www.trauma.org/index.php?/community/

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