Science Review: Vasopressin and the cardiovascular system part 2 - clinical physiology

Crit Care. 2004 Feb;8(1):15-23. doi: 10.1186/cc2338. Epub 2003 Jun 26.


Vasopressin is emerging as a rational therapy for vasodilatory shock states. In part 1 of the review we discussed the structure and function of the various vasopressin receptors. In part 2 we discuss vascular smooth muscle contraction pathways with an emphasis on the effects of vasopressin on ATP-sensitive K+ channels, nitric oxide pathways, and interaction with adrenergic agents. We explore the complex and contradictory studies of vasopressin on cardiac inotropy and coronary vascular tone. Finally, we summarize the clinical studies of vasopressin in shock states, which to date have been relatively small and have focused on physiologic outcomes. Because of potential adverse effects of vasopressin, clinical use of vasopressin in vasodilatory shock should await a randomized controlled trial of the effect of vasopressin's effect on outcomes such as organ failure and mortality.

Publication types

  • Review

MeSH terms

  • Animals
  • Cardiovascular Physiological Phenomena*
  • Clinical Trials as Topic
  • Humans
  • Muscle Contraction / drug effects
  • Muscle, Smooth, Vascular / drug effects*
  • Myocardial Contraction / drug effects
  • Potassium Channels / drug effects
  • Receptors, Vasopressin / chemistry
  • Receptors, Vasopressin / drug effects
  • Receptors, Vasopressin / physiology
  • Shock, Septic / drug therapy*
  • Shock, Septic / metabolism
  • Shock, Septic / physiopathology
  • Vasodilator Agents
  • Vasopressins / deficiency
  • Vasopressins / pharmacology
  • Vasopressins / therapeutic use*


  • Potassium Channels
  • Receptors, Vasopressin
  • Vasodilator Agents
  • Vasopressins