Effect of vasopressin on sublingual microcirculation in a patient with distributive shock

Objective: To assess the sublingual microcirculation in a patient during vasopressin administration for a distributive shock after cardiopulmonary bypass. Design and setting: Case-report in the Department of Intensive Care of a university hospital. Patient: A 53 year-old man developed severe distributive shock after cardiac transplant, requiring massive doses of vasopressor agents. Methods: Vasopressin administered twice at a dose of 0.02 U/min increased mean blood pressure and allowed partial weaning of other vasopressor drugs. Microcirculatory alterations were assessed by orthogonal polarization spectral technique: 50% and 60% of capillaries were perfused at baseline, and these proportions did not worsen when vasopressin was administered. Conclusions: Despite its strong vasopressor effects vasopressin infusion did not worsen microcirculatory alterations in this patient with distributive shock following cardiac surgery.