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British Journal of Anaesthesia 2007 99(2):154-158; doi:10.1093/bja/aem204
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Vasopressin and its antagonists: what are their roles in acute medical care?

The first 150 words of the full text of this article appear below.

Otherwise known as antidiuretic hormone, vasopressin is a small polypeptide of nine amino acids produced in the hypothalamus and secreted from the posterior pituitary gland. It was first identified more than 100 yr ago as a potent vasopressor. After production of a synthetic analogue in 1954 (for which Vincent Du Vigneaud from Cornell University, USA, received a Nobel Prize),1 high doses were found to produce coronary artery vasoconstriction. Until recently, vasopressin was largely used only as an antidiuretic agent to treat diabetes insipidus, but it is now being used as a vasopressor in a variety of disease states.

The most important physiological role of endogenous vasopressin is in control of fluid balance. Vasopressin is released when the sensitive osmoreceptors in the hypothalamus detect very small increases in extracellular fluid osmolality (mean threshold value 280 mOsm kg–1).2 It increases water reabsorption through the collecting ducts of the nephron. In contrast, . . . [Full Text of this Article]

When is vasopressin useful?

Organ donation
Cardiac arrest
Sepsis
Haemorrhagic shock
Anaesthesia for neuroendocrine tumours
Vasopressin antagonists

Heart failure
Hyponatraemia
S. L. M. Mitchell* and J.M. Hunter

Liverpool, UK

* E-mail: slmmitchell@hotmail.com


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