pituitrin and Pseudomonas-Infections

To describe a case of severe skin necrosis resulting from peripheral intravenous administration of low-dose vasopressin in a patient with catecholamine-resistant septic shock.. Case report.. Medical intensive care unit at the University of Chicago, Chicago, IL.. A 46-yr-old female with ventilator-dependent, proliferative-phase acute respiratory distress syndrome complicated by Pseudomonas aeruginosa bacteremia and sepsis.. A patient recovering from acute respiratory distress syndrome developed septic shock from Pseudomonas aeruginosa bacteremia while in the medical intensive care unit. Vasopressin (0.04 units/min) was administered through a peripheral venous catheter for hypotension unresponsive to exogenous catecholamines. The patient subsequently developed severe ischemic necrosis of the skin and soft tissue surrounding the catheter site. The vasopressin was stopped, and the skin lesion progressed to bullae formation with extensive superficial erosion.. Peripheral administration of low-dose vasopressin for septic shock should be discouraged because of the risk of ischemic skin complications.

Topics: Dose-Response Relationship, Drug; Extravasation of Diagnostic and Therapeutic Materials; Female; Humans; Illinois; Infusions, Intravenous; Middle Aged; Necrosis; Pseudomonas Infections; Shock, Septic; Skin; Treatment Failure; Vasoconstrictor Agents; Vasopressins

Topics: Female; Humans; Meningitis; Middle Aged; Pseudomonas aeruginosa; Pseudomonas Infections; Vasopressins

Topics: Aged; Aging; Alcaligenes; Aminohippuric Acids; Bacteriuria; Escherichia coli Infections; Female; Glomerular Filtration Rate; Humans; Infusions, Parenteral; Inulin; Kidney; Kidney Concentrating Ability; Kidney Function Tests; Klebsiella Infections; Male; Methods; Pseudomonas Infections; Staphylococcal Infections; Urinary Catheterization; Urinary Tract Infections; Vasopressins

Topics: Blood Chemical Analysis; Carbon Dioxide; Chlorides; Diabetes Insipidus; Diabetes Mellitus; Glucose Tolerance Test; Glycosuria; Hematuria; Humans; Hydronephrosis; Hyperglycemia; Nitrogen; Polyuria; Potassium; Pseudomonas Infections; Sodium; Urea; Urinary Tract Infections; Urine; Urography; Vasopressins

Topics: Colistin; Humans; Kidney Function Tests; Male; Pharmacology; Pseudomonas Infections; Pyelonephritis; Radioisotopes; Radionuclide Imaging; Staphylococcal Infections; Urography; Vasopressins