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Electronic Letters to:

Editorials:
S. L. M. Mitchell and J.M. Hunter
Vasopressin and its antagonists: what are their roles in acute medical care?
Br. J. Anaesth. 2007; 99: 154-158 [Full text] [PDF]
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Electronic letters published:

[Read E-letter] Use of Vasopressin in Anaphylaxis
Permendra Singh, S.H.Gururajarao   (6 November 2007)

Use of Vasopressin in Anaphylaxis 6 November 2007
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Permendra Singh ,
S.H.Gururajarao

Send letter to journal:
Re: Use of Vasopressin in Anaphylaxis

To the editor – It was interesting to read the recent editorial by Mitchell and Hunter regarding the role of Vasopressin and its antagonists in Acute Medical Care.

The author has described the uses of Vasopressin in medical practice and how it has evolved into a useful drug in life threatening situations.

We wanted to bring to light the other significant use of Vasopressin, which is in the management of anaphylactic shock. It is a relatively new concept to use Vasopressin in the management of anaphylaxis and the first case report we could find is from the year 2004.

Schummer et al(1) reported a 59 year old lady undergoing a coronary artery bypass graft surgery, who had a reaction to colloid infusion of Succinylated gelatin. This shock was unresponsive to routine management with Epinephrine and Norepinephrine and ultimately responded to 2 units of Vasopressin.

In a similar case report by Rocq et al(2) successful use of Terlipressin was shown in a patient who had an anaphylactic reaction to Suxamethonium.

Vasopressin has also been used for treatment of severe anaphylactic shock caused by sting of a hornet(3) . In this case after a bolus of 10 units patient was stablised with 40 units of infusion.

The above case reports suggest that adding Vasopressin to standard therapy for anaphylactic shock should be considered when Epinephrine alone does not restore vascular tone.

1 . Schummer W, Schummer C, Wipermann J, Juergan F: Anaphylactic shock: Is vasopressin the drug of choice? Anesthesiology 2004; 101:1025-7

2. Rocq N, Favier JC, Plancade D, Steiner T, Mertes PM : Successful use of terlipressin in post- cardiac arrest resuscitation after an epinephrine-resistant anaphylactic shock to suxamethonium. Anesthesiology 2007; 107:166-7

3 . Kill C, Wranze E, Wulf H: Successful treatment of severe anaphylactic shock with vasopressin. Int Arch Allergy Immunol 2004; 134:260-1

Conflict of Interest:

None declared