• V Rozenfeld and J W Cheng.
• Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, NY, USA.
• Ann Pharmacother. 2000 Feb 1;34(2):250-4.

ObjectiveTo review the role of vasopressin in the treatment of vasodilatory shock.Data SourcesA MEDLINE search on published reports (1966-April 1999) was conducted.Study SelectionEnglish-language studies and case reports were selected and evaluated based on quality of review of vasopressin in the treatment of vasodilatory shock.Data SynthesisIn patients with end-stage vasodilatory shock, baroreceptor reflex is impaired and vasopressin stores are depleted. Persistent elevation of catecholamines may lead to down-regulation of beta-adrenergic receptors and reduces smooth-muscle response to catecholamines, leading to inability of maintaining organ perfusion. Small-scale studies and case reports have demonstrated vasopressin's efficacy in maintaining blood pressure in patients with septic shock, cardiac arrest, and end-stage heart failure, refractory to other vasopressor therapies.ConclusionsVasopressin may be a reasonable alternative for patients in vasodilatory shock. However, larger-scale controlled dinical trials are warranted before its routine use can be recommended.

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