Vasopresina / Vasopressin

Agosto 15, 2017. No. 2781

Papel de la vasopresina en la práctica anestésica actual Role of vasopressin in current anesthetic practice. Park KS, Yoo KY. Korean J Anesthesiol. 2017 Jun;70(3):245-257. doi: 10.4097/kjae.2017.70.3.245. Epub 2017 May 26. Abstract Arginine vasopressin (AVP), also known as antidiuretic hormone, is a peptide endogenously secreted by the posterior pituitary in response to hyperosmolar plasma or systemic hypoperfusion states. When administered intravenously, it causes an intense peripheral vasoconstriction through stimulation of V1 receptors on the vascular smooth muscle. Patients in refractory shock associated with severe sepsis, cardiogenic or vasodilatory shock, or cardiopulmonary bypass have inappropriately low plasma levels of AVP ('relative vasopressin deficiency') and supersensitivity to exogenously-administered AVP. Low doses of AVP and its synthetic analog terlipressin can restore vasomotor tone in conditions that are resistant to catecholamines, with preservation of renal blood flow and urine output. They are also useful in the treatment of refractory arterial hypotension in patients chronically treated with renin-angiotensin system inhibitors, cardiac arrest, or bleeding esophageal varices. In the perioperative setting, they represent attractive adjunct vasopressors in advanced shock states that are unresponsive to conventional therapeutic strategies. KEYWORDS: Arginine vasopressin; Hemorrhagic shock; Refractory hypotension; Septic shock; Terlipressin; Vasodilatory shock PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information California Society of Anesthesiologists Reuniones / Events Informacion / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

Vasopresina / Vasopressin

Junio 12, 2017. No. 2717 Estimad@ Dr@ Víctor Valdés:

Papel de la vasopresina en la práctica anestésica actual. Parque KS, Yoo KY. Anesthesiol coreano J. 2017 Jun; 70 (3): 245 - 257. Resumen La arginina vasopresina (AVP), también conocida como hormona antidiurética, es un péptido secretado endógenamente por la pituitaria posterior en respuesta al plasma hiperosmolar o a estados de hipoperfusión sistémica. Cuando se administra intravenosamente, provoca una intensa vasoconstricción periférica a través de la estimulación de los receptores V1 en el músculo liso vascular. Los pacientes en choque refractario asociados con sepsis grave, shock cardiogénico o vasodilatador o bypass cardiopulmonar tienen niveles plasmáticos inadecuadamente bajos de AVP ("deficiencia relativa de vasopresina") y supersensibilidad a la AVP administrada exógenamente. Dosis bajas de AVP y su análogo sintético terlipressina puede restaurar el tono vasomotor en condiciones que son resistentes a las catecolaminas, con preservación del flujo sanguíneo renal y la producción de orina. También son útiles en el tratamiento de la hipotensión arterial refractaria en pacientes tratados crónicamente con inhibidores del sistema renina-angiotensina, paro cardíaco o varices esofágicas hemorrágicas. En el contexto perioperatorio, representan vasopresores adjuntos atractivos en estados de choque avanzados que no responden a las estrategias terapéuticas convencionales. PALABRAS CLAVE: Arginina vasopresina; Shock hemorrágico; Hipotensión refractaria; Shock séptico; Terlipresina; Shock vasodilatador Role of vasopressin in current anesthetic practice. Park KS1, Yoo KY1. Korean J Anesthesiol. 2017 Jun;70(3):245-257. doi: 10.4097/kjae.2017.70.3.245. Epub 2017 May 26. Abstract Arginine vasopressin (AVP), also known as antidiuretic hormone, is a peptide endogenously secreted by the posterior pituitary in response to hyperosmolar plasma or systemic hypoperfusion states. When administered intravenously, it causes an intense peripheral vasoconstriction through stimulation of V1 receptors on the vascular smooth muscle. Patients in refractory shock associated with severe sepsis, cardiogenic or vasodilatory shock, or cardiopulmonary bypass have inappropriately low plasma levels of AVP ('relative vasopressin deficiency') and supersensitivity to exogenously-administered AVP. Low doses of AVP and its synthetic analog terlipressin can restore vasomotor tone in conditions that are resistant to catecholamines, with preservation of renal blood flow and urine output. They are also useful in the treatment of refractory arterial hypotension in patients chronically treated with renin-angiotensin system inhibitors, cardiac arrest, or bleeding esophageal varices. In the perioperative setting, they represent attractive adjunct vasopressors in advanced shock states that are unresponsive to conventional therapeutic strategies. KEYWORDS: Arginine vasopressin; Hemorrhagic shock; Refractory hypotension; Septic shock; Terlipressin; Vasodilatory shock PDF

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org