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Can Large Doses Be Safely Given?

Harold V. Gaskill, III, MD; Kenneth R. Sirinek, MD; Barry A. Levine, MD

Arch Surg. 1983;118(4):434-437.

Abstract
• We evaluated the effects of intravenous (IV) vasopressin on central hemodynamics, as well as myocardial and gastrointestinal (GI) blood flow, to delineate an optimal dosage balanced to yield maximum reduction of GI blood flow with minimal adverse cardiac effects. Eight miniature swine were anesthetized, ventilated, catheterized, and infused with vasopressin for three consecutive 30-minute periods at logarithmically increasing doses (0.001, 0.01, and 0.1 units/kg/min). We determined cardiac output, systemic arterial pressure, and microsphere tissue blood flow after each infusion. We found that IV vasopressin (0.001 units/kg/min) produced substantial reductions in blood flow to the GI tract and heart, and reduced the cardiac index (3.0±0.4 to 2.1 ±0.3 L/sq m/min). Increased doses of vasopressin (x10 and x 100) decreased gastric mucosal blood flow even more, with minimal adverse effects on cardiac output and myocardial blood flow.

(Arch Surg 1983;118:434-437)

Author Affiliations
From the Surgical Service, Audie L. Murphy Memorial Veteran's Hospital (Drs Levine and Gaskill), and the Department of Surgery, University of Texas Health Science Center (Dr Sirinek), San Antonio.

Footnotes
Accepted for publication Oct 12, 1982.

Read before the Sixth Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Atlanta, May 14, 1982.

Reprint requests to Department of Surgery, University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78284 (Dr Levine).

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