Condition
Vasodilatory Shock
Vasodilatory shock is a life-threatening state in which blood vessels widen so much that blood pressure falls and organs receive too little blood. The evidence is strong for vasopressin: in a randomized trial, average blood pressure was higher at 24 hours when it was added to norepinephrine than with norepinephrine alone. That finding concerns blood pressure support in critically ill people who were already receiving standard care.
Sources: PMID 12732600; PMID 12534330
- Updated
- How we grade
- 46 studies cited
- Supplements studied
- 0
- Medicines and peptides
- 1
- Graded outcomes
- 4
No supplement studies yetWe haven’t found supplement studies for Vasodilatory Shock. The medicines and peptides studied for it are listed below.
Prescription medicines and peptides studied, for context
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Mortality (Less Severe Sepsis) VASST trial: 28-day mortality 26.5% vs 35.7% (p=0.05) in less severe septic shock. No benefit in more severe shock. | Improves (the measure goes down) | Moderate effect | 15 studies | |||
Studies that measured mortality (less severe sepsis) | ||||||
| Norepinephrine Sparing Significantly reduces norepinephrine dose requirements at 24 and 48 hours. Allows weaning of catecholamines. | Improves (the measure goes down) | Large effect | 11 studies | |||
Studies that measured norepinephrine sparing | ||||||
| Blood Pressure Support FDA-approved for maintaining blood pressure in vasodilatory shock. MAP significantly higher at 24h with AVP+NE vs NE alone. | Improves (the measure goes up) | Large effect | 10 studies | |||
Studies that measured blood pressure support
| ||||||
| Hemodynamic Stabilization Heart rate lower at 24-48h with AVP. Effective even in catecholamine-resistant vasodilatory shock. | Improves (the measure goes up) | Large effect | 10 studies | |||
Studies that measured hemodynamic stabilization
| ||||||
Key findings
- Mortality (Less Severe Sepsis)Improves (the measure goes down)
- Norepinephrine SparingImproves (the measure goes down)
- Blood Pressure SupportImproves (the measure goes up)
Studies cited
46 studies from PubMed
- Hemodynamic effects of adjunct arginine vasopressin to norepinephrine in septic shock: insights from a prospective multicenter registry study
- Characterization of a functional V(1B) vasopressin receptor in the male rat kidney: evidence for cross talk between V(1B) and V(2) receptor signaling pathways.
- Diabetes insipidus.
- Vasopressin and its analogues in shock states: a review
- Management of central diabetes insipidus.
- Gestational diabetes insipidus: Diagnosis and management.
- Diagnosis and differential diagnosis of diabetes insipidus: Update.
- Central Diabetes Insipidus Caused by Arginine Vasopressin Gene Mutation: Report of a Novel Mutation and Review of Literature.
- Genetic forms of neurohypophyseal diabetes insipidus.
- Perioperative urinary excretion of aquaporin-2 dependent upon vasopressin in cardiac surgery.
- [Nephrogenic syndrome of inappropriate antidiuresis].
- Diabetes insipidus.
- Reduced levels of vasopressin, an independent mechanism in the obesity paradox in patients with chronic heart failure: Insights from the DAMOCLES study.
- Arginine vasopressin antagonism in heart failure: Current status and possible new directions.
- Sleep quality is associated with vasopressin methylation in pregnant and postpartum women with a history of psychosocial stress.
- Vasopressin, Central Autonomic Control and Blood Pressure Regulation.
- Hydration for Health Conference Emphasizes Vasopressin and Kidney Diseases.
- [The pathway of vasopressin as a pharmacological target in nephrology: a narrative review].
- Pancreatic Neuroendocrine Tumor Producing Insulin and Vasopressin.
- Elevated vasopressin in pregnant mice induces T-helper subset alterations consistent with human preeclampsia.
- The Septic Shock 3.0 Definition and Trials: A Vasopressin and Septic Shock Trial Experience
- Central and peripheral roles of vasopressin in the circadian defense of body hydration.
- Cardiac effects of vasopressin.
- Vasopressin in septic shock: an individual patient data meta-analysis of randomised controlled trials
- Vasopressin versus norepinephrine infusion in patients with septic shock
- Vasopressin decreases sepsis-induced pulmonary inflammation through the V2R.
- Vasopressin: mechanisms of action on the vasculature in health and in septic shock.
- Effects of arginine vasopressin during resuscitation from hemorrhagic hypotension after traumatic brain injury
- [Nephrogenic diabetes insipidus].
- [Regulation by vasopressin of NaCl absorption in the renal collecting duct].
- Science Review: Vasopressin and the cardiovascular system part 2 - clinical physiology.
- Arginine vasopressin in advanced vasodilatory shock: a prospective, randomized, controlled study
- Management of vasodilatory shock: defining the role of arginine vasopressin
- Vasopressin: a new target for the treatment of heart failure
- [Indications of vasopressin in the management of septic shock].
- Science review: Vasopressin and the cardiovascular system part 1--receptor physiology.
- Low-dose vasopressin in the treatment of vasodilatory septic shock
- The role of vasopressin in the treatment of vasodilation in shock states.
- Vasopressin deficiency contributes to the vasodilation of septic shock
- A clinical review of the adaptive role of vasopressin in migraine.
- [Vasopressin, somatostatin and digestive hemorrhages in portal hypertension: the end of the tunnel?].
- Vasodilation associated with V2-type vasopressin activity: findings and implications.
- Vasopressin in circulatory control and hypertension.
- Central cardiovascular regulation and the role of vasopressin: a review.
- Contribution of vasopressin to hypertension.
- [Vasopressin isoreceptors in the liver and kidney: relationship between hormone binding and biological response].