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Minerva Anestesiologica 2002 November;68(11):855-9

Copyright © 2009 EDIZIONI MINERVA MEDICA

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


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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.

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