Intensive Care Medicine

, Volume 35, Issue 2, pp 355–359

Pilot safety study of low-dose vasopressin in non-septic critically ill children

  • Elisa Baldasso
  • Pedro Celiny Ramos Garcia
  • Jefferson Pedro Piva
  • Ricardo Garcia Branco
  • Robert Charles Tasker
Pediatric Brief Report

DOI: 10.1007/s00134-008-1392-1

Cite this article as:
Baldasso, E., Garcia, P.C.R., Piva, J.P. et al. Intensive Care Med (2009) 35: 355. doi:10.1007/s00134-008-1392-1

Abstract

Objective

To assess the safety of low-dose vasopressin infusion in critically ill children requiring prolonged mechanical ventilation (MV) at risk of developing sedation/analgesia-related hypotension.

Method

Randomized pilot safety study in children expected to require MV for at least 3 days. Children received either vasopressin (0.0005 U/kg/min) or sodium chloride (0.9%) infusion for a period of 48 h. Haemodynamic variables, urine output and serum electrolytes were closely monitored and analyzed.

Results

Twelve children in each group had similar baseline characteristics. Vasopressin infusion was associated with an 8 mmol/L fall in serum sodium concentration (p < 0.01) and with higher incidence of hyponatraemia (8 vs. 66%, p < 0.01). In normotensive children, low-dose vasopressin also induced a reversible decrease in urine output, and acutely increased blood pressure (p < 0.01). After stopping the vasopressin there was rebound hypotension (p < 0.01).

Conclusion

Low-dose vasopressin infusion in haemodynamically stable, but critically ill, children is associated with reduction in urine output and decreased serum sodium level, yielding a high incidence of hyponatraemia. We conclude that these effects limit further study of prophylactic vasopressin for sedation-related hypotension in a randomized controlled trial.

Keywords

Vasopressin Hypotension Shock Sedation Paediatric intensive care Mechanical ventilation 

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Elisa Baldasso
    • 1
    • 2
  • Pedro Celiny Ramos Garcia
    • 1
    • 2
  • Jefferson Pedro Piva
    • 1
    • 2
  • Ricardo Garcia Branco
    • 3
  • Robert Charles Tasker
    • 3
  1. 1.Pediatric Intensive Care Unit, Department of PediatricsHospital São Lucas da PUCRSPorto AlegreBrazil
  2. 2.Department of Paediatrics, Medical SchoolPontificia Universidade Catolica do Rio Grande do Sul (PUCRS)Porto AlegreBrazil
  3. 3.Department of Paediatrics, Box 116, School of Clinical MedicineUniversity of Cambridge, Addenbrookes HospitalCambridgeUK

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