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Use of Arginine Vasopressin in the Management of Vasodilatory Shock After CABG - A Clinical Tria.

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Author(s): Sanjay O | Kilpadi K | Prashanth P | Vincent V | Thejas B

Journal: Annals of Cardiac Anaesthesia
ISSN 0971-9784

Volume: 6;
Issue: 2;
Start page: 132;
Date: 2003;
Original page

ABSTRACT
Vasodilatory shock requiring treatment with catecholamines occurs in some patients following cardiopulmonary bypass. We investigated the use of vasopressin in the treatment of this syndrome. Forty patients with a left main coronary artery disease and a poor left ventricular function (ejection fraction 60 mm Hg and a systemic vascular resistance of greater than 900 dynes.sec.cm5 on maximal doses of pharmacological and mechanical support were selected. Patients underwent a standard cardiac anaesthesia protocol. All patients had a Swan-ganz catheter inserted pre-operatively. Arginine vasopressin was administered as a bolus of 0.015 units/kg intravenously followed by an infusion of 0.03 units/kg/hour. This dose increased the mean arterial pressure from 67+/-7 to 95+/-5 mm Hg and the systemic vascular resistance from 860+/-55 to 1502+/-71 dynes.sec.cm-5. It was also associated with a decrease in pharmacological support. All subjects responded to vasopressin administration. Vasopressin is an effective pressor in vasodilatory shock after cardiopulmonary bypass.

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