The long-term survival rate of catecholamine-resistant septic shock in Japanese patients who received vasopressin therapy

Clin Nephrol. 2009 Aug;72(2):129-36. doi: 10.5414/cnp72129.

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusions: In Japanese septic shock patients, vasopressin infusion improved hemodynamic status and reduced catecholamine requirement, and 28-day survival rate was 45%.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Pressure / drug effects
  • Blood Pressure / physiology
  • Cardiotonic Agents / pharmacology
  • Dopamine / pharmacology*
  • Dose-Response Relationship, Drug
  • Drug Resistance*
  • Drug Therapy, Combination
  • Follow-Up Studies
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / mortality*
  • Gram-Negative Bacterial Infections / physiopathology
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / mortality*
  • Gram-Positive Bacterial Infections / physiopathology
  • Humans
  • Infusions, Intravenous
  • Japan / epidemiology
  • Middle Aged
  • Norepinephrine / pharmacology*
  • Prospective Studies
  • Shock, Septic / drug therapy
  • Shock, Septic / mortality*
  • Shock, Septic / physiopathology
  • Survival Rate / trends
  • Time Factors
  • Treatment Outcome
  • Vasoconstrictor Agents / administration & dosage
  • Vasopressins / administration & dosage*

Substances

  • Cardiotonic Agents
  • Vasoconstrictor Agents
  • Vasopressins
  • Dopamine
  • Norepinephrine