Vasopressin for treatment of septic (vasodilatory) shock


Columbia University College Of Physicians and Surgeons


Donald W. Landry, MD, PhD, the Samuel Bard Professor and Chair of the Department of Medicine, and Juan A. Oliver, MD, Columbia University College of Physicians & Surgeons


While evaluating a woman with kidney failure and septic shock, Landry noticed that discontinuation of the hormone vasopressin, which had been given to stop esophageal bleeding, resulted in a sudden decrease in blood pressure. The medication, which is an anti-diuretic hormone, was not known to have an effect on blood pressure. But when the medication was administered again, the patient’s blood pressure increased. This observation led Landry and Oliver to explore the pathophysiology of vasodilatory shock, which can cause a life-threatening drop in blood pressure. They discovered that the condition triggers a vasopressin deficiency, which leads to a severe decrease in blood pressure. The deficiency can be countered by giving a very low dose of the drug. Vasopressin is now routinely used to increase blood pressure in patients with septic shock and vasodilatory shock after cardiopulmonary bypass.