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Critical Care

Open Access

The effect of vasopressin on gastric perfusion in catecholamine-dependent septic shock patients

  • FMP van Haren1,
  • FW Rozendaal1 and
  • JG van der Hoeven1
Critical Care20037(Suppl 2):P047

Published: 3 March 2003


NorepinephrineCatecholamineSeptic ShockVasopressinContinuous Infusion


Vasopressin increases blood pressure and decreases catecholamine requirements in septic shock patients [13]. Few clinically relevant data are available on the effect of vasopressin on the splanchnic circulation.


To study the effect of continuous infusion of vasopressin on the splanchnic circulation in septic shock patients.


Prospective clinical study.


Intensive care unit in a teaching hospital.


Eleven consecutive patients with documented septic shock who remained hypotensive despite norepinephrine infusion at a rate of ≥ 0.2 μg/kg per min.


Insertion of a gastric tonometry catheter; continuous infusion of vasopressin 0.04 U/min during 4 hours.

Measurements and main results

P(g–a)CO2 gap, blood pressure and cardiac index were recorded at baseline and after 15, 30, 60, 120 and 240 min.

The median P(g–a)CO2 gap increased from 5 mmHg at baseline to 19 mmHg after 4 hours (P = 0.022; Fig. 1). Blood pressure (mean ± SD) increased from 61 ± 13 mmHg at baseline to 68 ± 9 mmHg after 4 hours (P = 0.055). No significant changes in cardiac index were noted (P = 0.978). There was a strong correlation between median plasma levels of vasopressin and the median P(g–a)CO2 gap (r2 = 0.98) as is shown in Fig. 2.
Figure 1

Median P(g–a)CO2 gap (mmHg) with 25th and 75th percentiles.

Figure 2

Relationship between median plasma levels of vasopressin and median P(g–a)CO2 gap.


In norepinephrine-dependent septic shock patients, continuous infusion of low-dose vasopressin results in a significant and dose-dependent increase of the P(g–a)CO2 gap compatible with gastrointestinal hypoperfusion.

Authors’ Affiliations

Department of Intensive Care Medicine, Jeroen Bosch Hospital, Hertogenbosch, The Netherlands


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© BioMed Central Ltd 2003