Abstract
Many studies have recently shown the effectiveness of continuous vasopressin infusion in catecholamine-resistant septic shock, although controversial. We experienced a case of catecholamine-resistant septic shock effectively treated with continuous vasopressin infusion. A 79-year-old woman was admitted to our hospital because of dyspnea. The initial plain chest roentgenogram showed consolidation in the right lower lung. She was diagnosed as pneumonia and treated immediately. She suffered from septic shock and acute renal failure 3 hours after the admission. Her circulatory system was unstable and didn't effectively respond to catecholamines. At the hospital day 3, continuous infusions of norepinephrine 0.74μg·kg-1·min-1, dobutamine 2.2μg·kg-1·min-1 and dopamine 15.7μg·kg-1·min-1 has started but her circulatory system was still unstable. Continuous vasopressin infusion at a rate of 0.034IU·min-1 after bolus injection of vasopressin 5IU made it possible to wean from norepinephrine shortly. To avoid side effects of vasopressin, we terminated vasopressin in 48 hours. Finally, she recovered from septic shock without any severe side effects of vasopressin. This case demonstrates the effectiveness of continuous vasopressin infusion to control circulatory instability in catecholamine-resistant septic shock.
