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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
CLINICAL CASES CRITICAL CARE
Minerva Anestesiologica 2002 November;68(11):855-9
language: English, Italian
Role of desmopressin in the treatment of a case of septic shock refractory to catecholamines
Mignani V., Poleggi P., Conti G., Pennisi M. A., Marchese M.
Department of Anesthesia and Resuscitation Catholic University of the Sacred Heart, Rome
The authors describe a case of septic shock refractory to high-dose catecholamines after adequate volemic filling, rapidly corrected with the administration of desmopressin at a dose of 0.02 U/min. There are, in the literature, several cases of septic shock refractory to high-dose catecholamines successfully treated with arginine-vasopressin, a selective V1 agonist. This agent can potentially induce coronary vasoconstriction and presents a very difficult weaning, that imposes a slow reduction of the infusion amount. On the contrary, desmopressin does not present those adverse effects and is able to maintain a high renal blood flow, for its prevalent action on V2 instead of V1 receptors.