感染性休克患者停用血管加压素输注后发生尿崩症。
Diabetes insipidus after discontinuation of vasopressin infusion for septic shock.
作者信息
Rana H, Ferguson N, Dicpinigaitis P V
机构信息
Division of Critical Care Medicine, Montefiore Medical Center, Bronx, NY, USA.
Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
出版信息
J Clin Pharm Ther. 2018 Apr;43(2):287-290. doi: 10.1111/jcpt.12627. Epub 2017 Sep 11.
WHAT IS KNOWN AND OBJECTIVE
Despite widespread use of vasopressin for the treatment of septic shock, few cases of diabetes insipidus (DI) following its discontinuation have been reported.
CASE SUMMARY
A 54-year-old man presented with pneumonia progressing to septic shock, requiring norepinephrine and vasopressin for refractory hypotension. After clinical improvement, the patient on 3 separate occasions developed polyuria and severe hypernatremia upon discontinuation of vasopressin, with prompt recovery upon its resumption.
WHAT IS NEW AND CONCLUSION
Occurrence of DI upon discontinuation of vasopressin infusion appears to be rare, but incidence may be underestimated due to a paucity of published reports. Actual incidence and underlying mechanism of this phenomenon remain to be elucidated.
已知信息与目的
尽管血管加压素在脓毒性休克治疗中广泛应用，但停用后发生尿崩症（DI）的病例报道较少。
病例摘要
一名54岁男性因肺炎进展为脓毒性休克，因顽固性低血压需要去甲肾上腺素和血管加压素治疗。临床症状改善后，患者在3次分别停用血管加压素时出现多尿和严重高钠血症，恢复使用后迅速好转。
新发现与结论
停用血管加压素输注后发生尿崩症似乎罕见，但由于发表的报告较少，发病率可能被低估。这一现象的实际发病率和潜在机制仍有待阐明。
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