ICM Case Summaries - December 7, 2016
..."Adjunctive vasopressin infusion is useful in septic shock where target MAP is difficult to achieve without high noradrenaline requirements. There is no clear mortality benefit associated with this, though it may attenuate some potentially harmful consequences seen with high-dose catecholamine use. Conceptually it appears ideally suited to cirrhotic patients with septic shock. Although synthetic vasopressin analogues have theoretical advantages to vasopressin itself, there is not enough evidence to justify their use routinely. Bolus use of vasopressin analogues for septic shock, outside of cirrhotic patients with associated gastrointestinal haemorrhage or hepatorenal syndrome, cannot be recommended at this time."