Vasopressin substitution causes microcirculatory changes in patients with septic shock

Introduction

We tested the effects of arginine vasopressin on tissue oxygenation, microvascular reactivity and oral mucosa microcirculation in patients with septic shock.

Methods

In 20 patients with septic shock, tissue microcirculation was determined before treatment with AVP (2 IU/hour), after 2 hours of treatment and 2 hours after treatment.

The thenar muscle StO₂ was measured by near-infrared spectroscopy (InSpectra; Hutchinson Technology, Hutchinson, MN, USA). Oral mucosal tissue oxygen saturation, microcirculatory blood flow and blood flow velocity were measured in depths of 1 and 4 mm with a laser Doppler flowmetry and remission spectroscopy system (O₂C).

Results

See Table 1. Vasopressin infusion led to a significant decrease of oral mucosal oxygen saturation and blood flow, and a significant decrease of flow velocity in a depth of 1 mm. Changes in thenar tissue perfusion were not detectable.

Table 1 (abstract P34)

Conclusion

Vasopressin causes a deterioration of oral mucosal blood flow but not in thenar tissue perfusion.