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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Monday, March 2, 2020

AVP in Haemorrhagic Shock

St Emlyn’s - Craig Ferguson - March 2, 2020
"Blood product transfusion can be lifesaving for patients who have suffered major trauma, but the associated side-effects and risks, mean that most people would agree that less is more. This paper by Sim et al examines whether giving arginine vasopressin (AVP) can reduce blood product requirements in patients receiving massive transfusions following trauma. 
Effect of Low-Dose Supplementation of Arginine Vasopressin on Need for Blood Product Transfusions in Patients With Trauma and Hemorrhagic Shock. A Randomized Clinical Trial. JAMA Surg. 2019;154(11):994-1003. doi:10.1001/jamasurg.2019.2884
Bottom Line?
This paper suggests that the use of AVP did reduce the administration of blood products in major trauma patients requiring transfusion of more than six units; however, this failed to translate into any measurable clinical outcome, other than the unexpected reduction in DVT incidence, so I don’t think I’m ready to change my practice yet. 
The authors suggest a further, larger study is required to demonstrate the true effect but given the lack of demonstrated clinical benefit, and the small number of patients that this is applicable to, it may be some time before this is completed."