Abstract
Persistent hypotension, or refractory hypotension, is frequently observed as an adverse event intraoperatively. Various conditions, including chronic hypertension, metabolic acidosis, and/or methamphetamine misuse, may lead to catecholamine desensitization. As consequence of catecholamine resistance, hypotension is often unresolved by administration of commonly used vasopressors like phenylephrine, ephedrine, epinephrine, and/or norepinephrine. It is essential that persistent hypotension is treated promptly in effort to avoid end-organ ischemia and subsequent mortality risks. Vasopressin use may spare progressive catecholamine depletion through a separate mechanism of action that increase blood pressure and perfusion to vital organs. During an observed case, a 43-year-old male patient with a history of chronic hypertension, generalized anxiety, and methamphetamine misuse underwent a shoulder arthroscopy. Following placement in a sitting position, the patient experienced hypotension that was not responsive to phenylephrine, ephedrine, and fluid boluses. In effort to optimize cerebral perfusion, the patient received 2 consecutive boluses of vasopressin, resulting in stabilization of blood pressure back to the patient’s baseline. This case scenario elucidates the benefits of early use of vasopressin in the incident of unresolved hypotension.
Sigma Membership
Non-member
Type
DNP Capstone Project
Format Type
Text-based Document
Study Design/Type
Case Study/Series
Research Approach
Translational Research/Evidence-based Practice
Keywords:
Vasopressin, Catecholamine, Refractory Hypotension
Advisor
Terri M. Cahoon
Degree
DNP
Degree Grantor
Samford University
Degree Year
2025
Recommended Citation
Capps, Hannah E., "Vasopressin as a Catecholamine-Sparing Mechanism" (2025). Group: Samford University Moffett & Sanders School of Nursing. 189.
https://www.sigmarepository.org/samford/189
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Review Type
None: Degree-based Submission
Acquisition
Proxy-submission
Full Text of Presentation
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