To the Editors:
As an RN at Columbia Presbyterian’s cardiothoracic intensive care unit, I read with great interest the article “Vasopressin in the Cardiac Surgery Intensive Care Unit” (July 2002:326–330). We are privileged to be working with Dr Landry as well as with the cardiac surgeons who have been applying his groundbreaking vasopressin research in cardiac surgery patients.
Our nurses are quite familiar with the use of vasopressin infusions in the setting of shock, and it is one of the mainstays of pharmacologic therapy in our unit. I must therefore take immediate issue with your dosing recommendations and point out the dangerous inconsistencies in the tables and the text of the article. There are 2 instances where dosing is correctly described, ie, on page 329, “Research to date indicates that a dosing range of 0.01 up to 0.1 U/min is most effective in patients with vasodilatory shock without causing any...