Early Vasopressin Infusion
Hemorrhagic shock is a life-threatening emergency occurring in prehospital as well as in hospital settings. In the battlefield and in civilian settings, severe bleeding from traumatic injury is an important and potentially preventable cause of death. The Tactical Combat Casualty Care (TCCC) developed for wounded warriors and also implemented in civilian trauma, emphasizes – besides control of the bleeding source – restrictive fluid resuscitation to avoid exacerbation of the acute traumatic coagulopathy.
Work at the Resuscitation Institute supported by awards from the Department of Defense, has shown in various swine models of hemorrhagic shock improved survival by early and sustained administration of vasopressin delivered through the intraosseous route while maintaining restrictive fluid resuscitation.1-3
- Borovnik-Lesjak V, Whitehouse K, Baetiong A, Miao Y, Currie BM, Velmurugan S, Radhakrishnan J, Gazmuri RJ. Effects of intraosseous erythropoietin during hemorrhagic shock in swine. PLoS One. 2014 Nov 3;9(11):e110908.
- Gazmuri RJ, Whitehouse K, Whittinghill K, Baetiong A, Radhakrishnan J. Vasopressin Infusion with Small-Volume Fluid Resuscitation during Hemorrhagic Shock Promotes Hemodynamic Stability and Survival in Swine. PLoS One. 2015 Jun 24;10(6):e0130134.
- Gazmuri RJ, Whitehouse K, Whittinghill K, Baetiong A, Shah K, Radhakrishnan J. Early and sustained vasopressin infusion augments the hemodynamic efficacy of restrictive fluid resuscitation and improves survival in a liver laceration model of hemorrhagic shock. J Trauma Acute Care Surg. 2017 Feb;82(2):317-327.
We plan to develop strategies to translate our preclinical findings to military and civilian settings. Stay tuned…