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Published ahead of print on June 5, 2003, doi:10.1164/rccm.200205-447OC
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American Journal of Respiratory and Critical Care Medicine Vol 168. pp. 481-486, (2003)
© 2003 American Thoracic Society

Original Article

Low-Dose Vasopressin in the Treatment of Septic Shock in Sheep

Qinghua Sun, George Dimopoulos, Duc Nam Nguyen, Zizhi Tu, Nathalie Nagy, Anh Dung Hoang, Peter Rogiers, Daniel De Backer and Jean-Louis Vincent

Department of Intensive Care, Erasme Hospital, Free University of Brussels, Brussels, Belgium

Correspondence and requests for reprints should be addressed to Jean-Louis Vincent, M.D., Ph.D. Department of Intensive Care, Erasme University Hospital, Route de Lennik 808, B-1070 Brussels, Belgium. E-mail: jlvincen{at}ulb.ac.be

After induction of cecal perforation, 20 anesthetized sheep were randomized to be treated, when arterial blood pressure fell below 75 mm Hg, with vasopressin (fixed dose of 0.02 U/minute), norepinephrine (0.5–5 µg/kg/minute titrated to maintain mean arterial pressure between 75 and 85 mm Hg), vasopressin + norepinephrine (vasopressin at fixed dose 0.01 U/minute plus norepinephrine titrated as for norepinephrine only group), or no vasopressor (Ringer's lactate [control]). Mean arterial pressure was well maintained in all treatment groups. Superior mesenteric arterial blood flow was significantly lower in the vasopressin + norepinephrine group than in the vasopressin group. Vasopressin alone or combined with norepinephrine limited the increase in blood lactate concentration and ileal PCO2-gap compared with control and norepinephrine groups. Urine output was higher in the vasopressin group than in control and norepinephrine groups. Survival time was longer in the vasopressin (30 ± 6 hours) and vasopressin + norepinephrine (30 ± 3 hours) groups than in the norepinephrine group (20 ± 1 hours, p < 0.05) and in all treatment groups than in the control group (17 ± 2 hours, p < 0.05). Tissue injury was less severe in the vasopressin and vasopressin + norepinephrine groups than in the others. In this clinically relevant model of septic shock due to peritonitis, vasopressin administration (alone or with norepinephrine) can prolong survival.

Key Words: norepinephrine • peritonitis • sheep • survival time • histologic abnormality




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