The author reviews normal physiological mechanisms of endogenous vasopressin, describes clinical benefits and adverse reactions associated with exogenous arginine vasopressin, and provides recommendations for nursing care of patients who require the exogenous form.

In this article, I examine the role of exogenous arginine vasopressin in catecholamine-refractory septic shock. I review normal physiological mechanisms of endogenous vasopressin, describe clinical benefits and adverse reactions associated with use of exogenous arginine vasopressin, and provide recommendations for nursing care of patients who require the exogenous form.

A 54-year-old man with staphylococcal septicemia is admitted to the intensive care unit for mechanical ventilation, hemodynamic support, and invasive monitoring. Despite antibiotic therapy, multiple fluid boluses, and the continuous administration of norepinephrine at 5 μg/min, his mean arterial pressure (MAP) remains less than 60 mm/Hg. After consultation with the interdisciplinary team, the decision is made to...

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