Intravenous arginine vasopressin in critically ill children: Is it beneficial?

Ori Efrati*, Dalit Modan-Moses, Amir Vardi, Ilan Matok, Zohar Bazilay, Gideon Paret

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Arginine-vasopressin (AVP) may be more effective than epinephrine in shock states and as an end-of-life salvage maneuver. However, there is only limited experience using AVP in children. Our study aim was to evaluate the effect of AVP administration on hemodynamic and ventilatory parameters in critically ill children. Eight critically ill children (1 month to 12 years old) were treated with AVP during the years 2000-2001. Two patients had had head trauma, and six had surgical correction of congenital heart disease. All patients suffered severe septic or cardiogenic shock with a low cardiac output state and were considered to be near death. AVP was administered continuously at a dose of 0.0003-0.002 U/kg/min. Hemodynamic and ventilatory parameters and vasopressor doses were compared before and after AVP initiation. One patient survived with a good neurologic outcome. Seven patients succumbed while receiving AVP. Systolic and diastolic blood pressure increased significantly (P < 0.03) following AVP initiation. The epinephrine requirement decreased from 2.3 to 1.7 μg/kg/min. Blood gases improved with a significant (P < 0.05) increase of PaO2. Oxygenation index and PaO2/FiO2 ratio improved significantly, and ventilatory support requirements and positive inspiratory pressure (PIP) decreased significantly. Despite a significant improvement in hemodynamic and ventilatory support parameters, survival to hospital discharge was not achieved when AVP was used in critically ill pediatric patients. We hypothesize that earlier administration of AVP may be more beneficial.

Original languageAmerican English
Pages (from-to)213-217
Number of pages5
Issue number3
StatePublished - Sep 2004
Externally publishedYes


  • Cardiogenic shock
  • Epinephrine requirements
  • Hemodynamic effects
  • Septic shock
  • Ventilatory parameters


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