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Does endogenous vasopressin influence the outcome of resuscitation?
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A fascinating question which was raised since there are hints in human medicine that the patients who are resuscitated successfully have significantly higher endogenous vasopressin levels than the patients who died. There might be a benefit of administering vasopressin during cardiopulmonary resuscitation (CPR).
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Several CPR studies in pigs showed that vasopressin improved blood flow to vital organs, cerebral oxygen delivery, resuscitability and neurological outcome when compared with epinephrine.
In a small clinical study, vasopressin significantly improved short-term survival when compared with epinephrine indicating its potential as an alternative pressor to epinephrine during CPR in human beings.
As there was little clinical data available at that time, its recommended use was limited to adult human beings with shock-refractory ventricular fibrillation.
In this report, we present the case of a dog in which the successful management of intraoperative asystolic cardiac arrest involved vasopressin.
Unexpected cardiac arrest occurred during anaesthesia for the surgical removal of multiple mammary adenocarcinomata in a 11-year-old Yorkshire terrier.
Despite an ASA physical status assignation of III, the dog was successfully resuscitated with external chest compressions, intermittent positive pressure ventilation and vasopressin (2 doses of 0.8 IU kg1) and was discharged 3 days later without signs of neurological injury.
We believe vasopressin contributed to restoring spontaneous circulation. It may prove increasingly useful in perioperative resuscitation in dogs.
Source: Christian A Schmittinger, Sandra Astner, Leonhard Astner, Josef Kössler, Volker Wenzel (2005): Cardiopulmonary resuscitation with vasopressin in a dog. In: Veterinary Anaesthesia and Analgesia 32 (2), 112-114.
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