Table 3.
Studies of vasopressin in humans with septic shock. A conglomeration of studies investigating the effects of vasopressin (antidiuretic hormone; [ADH]) in humans with septic shock
| Reference | Design | Patient Population/disease | Number of patients | Comparison | Vasopressin Dose Units/minutes | Outcomes |
|---|---|---|---|---|---|---|
| Landry et al 1997b | Prospective, open-label, unrandomized | Septic shock on catecholamines | 10 | Pre- vs Post-ADH | 0.04 U/min | ↑ BP |
| Landry et al 1997b | Prospective, open-label, unrandomized | Septic shock on catecholamines | 6 | Pre- vs Post-ADH | 0.01 U/min | ↑ BP |
| Landry et al 1997b | Prospective, open-label, unrandomized, removal of ADH | Septic shock on catecholamines | 6 | On ADH vs Post-stopping ADH | 0.01 U/min | ↓ BP on removal of ADH |
| Landry et al 1997a | Prospective, open-label, unrandomized case reports | Septic shock on catecholamines | 5 | Pre- vs Post-ADH | 0.03–0.04 U/min | ↑ BP, ↓ Cat, ↑ UO |
| Malay et al 1999 | Prospective, randomized, placebo-controlled, double-blinded | Trauma patients with septic shock on catecholamines | 10 | ADH (n = 5) vs Placebo (n = 5) | 0.04 U/min | ↑ BP, ↓ NE |
| Dunser et al 2001 | Retrospective | Septic (n = 35) or post-cardiotomy shock (n = 25) on catecholamines | 60 | Pre- vs Post-ADH | 0.07–0.1 U/min | ↑ BP, ↓ NE, ↓ HR, ↓ CI, ↓ mean PAP, ↑ liver enzymes, ↓ plt |
| Holmes, Walley, et al 2001 | Retrospective | Septic shock on catecholamines | 50 | Pre- vs Post-ADH | 0.01–0.6 U/min (avg. 0.5 U/min) | ↑ BP, ↓ Cat, ↑UO, ↓ CI |
| Tsuneyoshi et al 2001 | Prospective, open-label | Septic shock on catecholamines | 16 | Pre- vs Post-ADH | 0.04 U/min | ↑ BP, ↑ UO |
| Patel et al 2002 | Prospective, randomized, blinded | Septic shock | 24 | ADH (n = 13) vs NE (n = 11) | 0.01 U/min titrated up to 0.08 U/min | ↑ BP, ↓ NE, ↑ UO, ↑ CCl |
| Dunser et al 2003 | Prospective, randomized, blinded | Cardiopulmonary bypass ± septic shock | 48 | NE + ADH (n = 24) vs NE alone (n = 24) | 0.067 U/min | ↑ BP ↓ tachyarrhythmias |
Abbreviations: ADH, antidiuretic hormone; BP, blood pressure; Cat, catecholamines; CCl, creatinine clearance; CI, cardiac index; HR, heart rate; NE, norepinephrine; PAP, pulmonary artery pressure; plt, platelets; PVR, peripheral vascular resistance; SVR, systemic vascular resistance; U/min, units/minute; UO, urinary output.