Abstract: Arginine vasopressin (AVP) is closely related to the pathogenesis of a variety of cardiovascular diseases and kidney diseases. Currently it is often used for the treatment of severe peripheral vasodilatory shock, and particularly beneficial for patients with refractory catecholamine-resistant vasodilatory shock. For some patients who do not have adequate AVP level in plasma after cardiovascular surgery, external low-dose AVP infusion is helpful to decrease the heart rate, and the dosage and duration of catecholamine use. Early initiation of low-dose AVP infusion may be beneficial for postoperative patients’ hemodynamic recovery without adverse complications. More randomized control trials are needed to provide evidence for rational usage, dosage and duration of AVP administration.
The hemodynamic management of adult patients with distributed shock often includes the use of catecholamines vasoconstrictor drugs. It was unclear whether adding vasopressin or vasopressin analogs to catecholamine therapy was beneficial for the treatment of patients with distributed shock. The Canadian Society of Intensive Care recently updated its clinical practice guideline to provide recommendations for the addition of vasopressin to catecholamine boosters in adults with distributed shock. This paper interprets it to assist domestic doctors for better understanding of the latest progress.