Vasopressin for hemorrhagic shock management: revisiting the potential value in civilian and combat casualty care.
J Trauma
; 69 Suppl 1: S69-74, 2010 Jul.
Article
en En
| MEDLINE
| ID: mdl-20622623
ABSTRACT
The evolution of trauma care is driven by a synergistic relationship between civilian and military medical systems. Although the characteristics of civilian injuries differ from those encountered on the battlefield, the pathophysiologic process of dying is the same and dominated by exsanguination and central nervous trauma. As such, therapies that interfere with the physiologic ability to compensate hemorrhage may play a key role to buy time until hemostatic surgery can be initiated. From a variety of remedies with the potential to prolong the compensation phase or to reverse the decompensation phase of shock, arginine vasopressin (AVP) is one of the most promising and best-evaluated drugs. Animal studies and various case report series provide some evidence that AVP may improve blood pressure even when conventional therapies fail, thus preventing hypovolemic cardiac arrest and enabling resuscitation from fatal hemorrhage. On the basis of this civilian experience, it seems reasonable to consider AVP for hypotensive resuscitation in the austere, resource-constrained battlefield environment. However, the significance of AVP as a rescue medication for life-threatening hemorrhage has yet to be proven.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Resucitación
/
Choque Hemorrágico
/
Guerra
/
Heridas y Lesiones
/
Vasopresinas
/
Incidentes con Víctimas en Masa
Tipo de estudio:
Etiology_studies
Límite:
Humans
Idioma:
En
Revista:
J Trauma
Año:
2010
Tipo del documento:
Article
País de afiliación:
Austria