Sawa N, Ubara Y, Katori H, Hoshino J, Suwabe T, Takemoto F, Uchida N, Masuoka K, Wake A, Taniguchi S, Takaichi K
Departments of Nephrology, Toranomon Hospital, Tokyo, Japan.
Clin Nephrol. 2009 Aug;72(2):129-36. doi: 10.5414/cnp72129.
Septic shock is associated with vasopressin deficiency and hypersensitivity to its exogenous administration. The aim of this study is to review the 28-day survival rate, hemodynamic and renal effects of vasopressin therapy in refractory septic shock Japanese patients.
55 Japanese patients experiencing catecholamine-resistant septic shock were treated with vasopressin. Hemodynamic alterations and the serum concentrations of aspartate aminotransferase, total bilirubin and creatinine clearance were evaluated following vasopressin treatment.
In both, survivors and non-surviving patients, treatment with vasopressin resulted in a significantly increase in mean arterial pressure, hourly urine output, and a significant decrease in heart rate and total pressor dosage requirements. Creatinine clearance was significantly increased only in survivors. There were no significant changes in the serum concentrations of aspartate aminotransferase and total bilirubin. The 28-day survival rate was 45% (25 patients).
In Japanese septic shock patients, vasopressin infusion improved hemodynamic status and reduced catecholamine requirement, and 28-day survival rate was 45%.
感染性休克与血管加压素缺乏及对外源性血管加压素的超敏反应有关。本研究旨在回顾血管加压素治疗难治性感染性休克日本患者的28天生存率、血流动力学及肾脏效应。
55例对儿茶酚胺耐药的感染性休克日本患者接受血管加压素治疗。血管加压素治疗后评估血流动力学改变以及血清天冬氨酸氨基转移酶、总胆红素浓度和肌酐清除率。
在存活和未存活患者中,血管加压素治疗均导致平均动脉压显著升高、每小时尿量显著增加,心率和总升压药剂量需求显著降低。仅存活患者的肌酐清除率显著升高。血清天冬氨酸氨基转移酶和总胆红素浓度无显著变化。28天生存率为45%(25例患者)。
在日本感染性休克患者中,输注血管加压素改善了血流动力学状态并减少了儿茶酚胺需求,28天生存率为45%。