This review of the use of vasopressin aims to be comprehensive and highly practical, based on the available scientific evidence and our extensive clinical experience with the drug. It summarizes controversies about vasopressin use in septic shock and other vasodilatory states. Vasopressin is a natural hormone with powerful vasoconstrictive effects and is responsible for the regulation of plasma osmolality by maintaining fluid homeostasis. Septic shock is defined by the need for vasopressors to correct hypotension and lactic acidosis secondary to infection, with a high mortality rate. The Surviving Sepsis Campaign guidelines recommend vasopressin as a second-line vasopressor, added to norepinephrine. However, these guidelines do not address specific debates surrounding the use of vasopressin in real-world clinical practice.
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http://dx.doi.org/10.3390/jpm13111548 | DOI Listing |
Zhonghua Yi Xue Za Zhi
January 2025
Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics, Laboratory of Infection and Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing100045, China.
In recent years, particularly since the outbreaks of scarlet fever and invasive group A streptococcal diseases/infections (iGAS) in several European countries in 2022, iGAS has garnered widespread attention. Recently, Japan experienced an outbreak of a specific type of iGAS, streptococcal toxic shock syndrome (STSS). The outbreak was reported under the label"flesh-eating bacteria,"emphasizing the pathogenic potential of group A streptococcus (GAS).
View Article and Find Full Text PDFRen Fail
December 2025
Department of Critical Care Medicine, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R, China.
Introduction: Sepsis is an uncontrolled systemic response to infection that leads to life-threatening organ dysfunction. The in-hospital mortality rate remains significantly high in septic shock patients with malignancies. This study investigates whether early and high-volume administration of sodium bicarbonate during continuous renal replacement therapy (CRRT) can reduce 28-day mortality, increase shock reversal rates, and shorten the duration of CRRT, mechanical ventilation, and intensive care unit (ICU) stays.
View Article and Find Full Text PDFBMJ Open
December 2024
Department of Infectious Diseases, Skånes universitetssjukhus Malmö, Malmö, Skåne, Sweden
Objectives: A rising incidence of septic shock as well as recommendations for early vasopressor initiation has increased the number of patients eligible for norepinephrine (NE). Traditionally, NE has been administered through central lines, in intensive care units, due to the risk of extravasation in peripheral lines. The aim of the current study is to determine the rate of complications and patient outcomes when NE is administered through midline catheters (MCs) in intermediary care units (IMCUs).
View Article and Find Full Text PDFBackground: High levels of catecholamines are cardiotoxic and associated with stress-induced cardiomyopathies. Septic patients are routinely exposed to endogenously released and exogenously administered catecholamines, which may alter cardiac function and perfusion causing ischemia. Early during human septic shock, left ventricular ejection fraction (LVEF) decreases but normalizes in survivors over 7-10 days.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK.
Malaria is highly prevalent in West and Central Africa. In the United States, most reported cases are due to immigration from endemic regions. Severe malaria caused by Plasmodium ovale is rare.
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