Effect of vasopressin on sublingual microcirculation in a patient with distributive shock

Intensive Care Med. 2003 Jun;29(6):1020-1023. doi: 10.1007/s00134-003-1742-y. Epub 2003 May 8.

Abstract

Objective: To assess the sublingual microcirculation in a patient during vasopressin administration for a distributive shock after cardiopulmonary bypass.

Design and setting: Case-report in the Department of Intensive Care of a university hospital.

Patient: A 53 year-old man developed severe distributive shock after cardiac transplant, requiring massive doses of vasopressor agents.

Methods: Vasopressin administered twice at a dose of 0.02 U/min increased mean blood pressure and allowed partial weaning of other vasopressor drugs. Microcirculatory alterations were assessed by orthogonal polarization spectral technique: 50% and 60% of capillaries were perfused at baseline, and these proportions did not worsen when vasopressin was administered.

Conclusions: Despite its strong vasopressor effects vasopressin infusion did not worsen microcirculatory alterations in this patient with distributive shock following cardiac surgery.

Publication types

  • Case Reports

MeSH terms

  • Blood Pressure / drug effects
  • Cardiomyopathies / surgery
  • Cardiopulmonary Bypass / adverse effects*
  • Central Venous Pressure / drug effects
  • Fluorescence Polarization
  • Heart Rate / drug effects
  • Heart Transplantation / adverse effects
  • Hemodynamics / drug effects
  • Humans
  • Infusions, Intravenous
  • Male
  • Microcirculation / drug effects*
  • Middle Aged
  • Mouth Floor / blood supply*
  • Oxygen Consumption / drug effects
  • Pulmonary Wedge Pressure / drug effects
  • Shock, Cardiogenic / drug therapy*
  • Shock, Cardiogenic / etiology
  • Shock, Cardiogenic / physiopathology
  • Spectrometry, Fluorescence
  • Vasoconstrictor Agents / pharmacology
  • Vasoconstrictor Agents / therapeutic use*
  • Vasopressins / pharmacology
  • Vasopressins / therapeutic use*

Substances

  • Vasoconstrictor Agents
  • Vasopressins