To the Editor:—
We read with great interest the report by Patel et al. on beneficial effects of short-term infusion of vasopressin for severe septic shock. 1The authors reported that for 24 patients with severe septic shock, 4 h infusion of vasopressin spared norepinephrine to maintain mean arterial pressure and improved urine output and creatinine clearance compared with the control group (norepinephrine infusion) in a double-blinded, randomized, controlled fashion. We were impressed with the results showing that low-dose vasopressin therapy may increase survival of septic shock. However, there was no information about the outcome of their patients. To survive from severe septic shock, there may be a need for long-term vasopressin infusion to maintain stable cardiovascular status. Dunser et al. demonstrates 72-h vasopressin infusion brings about a significant increase in liver enzymes and total bilirubin concentration and a significant decrease in platelet count. 2
