Vasopressin as an alternative to norepinephrine in the treatment of milrinone-induced hypotension

Objective: To determine whether vasopressin could be effective in treating the hypotension associated with phosphodiesterase III inhibition, Phosphodi esterase III inhibitors are cardiotonic agents that increase myocardial con tractility and decrease vascular smooth muscle tone. The vasodilatory effec t can be profound, and the resulting hypotension frequently requires the ad ministration of catecholamine pressors, Design: Retrospective analysis of existing data. Setting: The medical or surgical intensive care unit of Columbia-Presbyteri an Medical Center. Patients: Three consecutive patients receiving milrinone and requiring cate cholamine pressors to maintain systolic arterial pressure of greater than o r equal to 90 mm Hg, lnterventions: Vasopressin was administered to the three patients, Measurements and Main Results: Vasopressin (0.03-0.07 units/min) increased systolic arterial pressure from 90 +/- 4.7 to 130 +/- 2.3 mm Hg while reduc ing the administration of catecholamine pressors. Conclusions: Vasopressin at very low doses appears to be an effective vasop ressor for milrinone-induced hypotension.