๋ฐ”์†Œํ”„๋ ˆ์‹  / Vasopressin

์ •์˜

ADH ๊ณ„์—ด ํ˜ˆ๊ด€์ˆ˜์ถ•์ œ๋กœ, ํŒจํ˜ˆ์„ฑ ์‡ผํฌ์—์„œ norepinephrine ๋ณด์กฐ์ œ๋กœ ์‚ฌ์šฉ๋œ๋‹ค.

์ž„์ƒ ํ•ต์‹ฌ

์ž๋ฃŒ์—์„œ๋Š” NE ๋‹ค์Œ ๋‹จ๊ณ„์˜ vasopressor๋กœ ์ •๋ฆฌํ•œ๋‹ค. ๋ฐ˜๊ฐ๊ธฐ๋Š” 10โ€“20๋ถ„์œผ๋กœ ์–ธ๊ธ‰๋œ๋‹ค. NE์™€ epinephrine ๊ฐ™์€ catecholamine ์‚ฌ์šฉ๋Ÿ‰์„ ์ค„์ด๋Š” catecholamine-sparing effect๊ฐ€ ์žˆ๋‹ค.

์ง„๋‹จ

NE ์š”๊ตฌ๋Ÿ‰์ด ์ฆ๊ฐ€ํ•˜๊ฑฐ๋‚˜ ์ €ํ˜ˆ์••์ด ์ง€์†๋  ๋•Œ ์ถ”๊ฐ€๋ฅผ ๊ณ ๋ คํ•œ๋‹ค. ์ž๋ฃŒ์—์„œ๋Š” NE๊ฐ€ ์•ฝ 15cc/hr ์ •๋„ ๋˜๋ฉด vasopressin start๋ฅผ ์–ธ๊ธ‰ํ•œ๋‹ค.

์น˜๋ฃŒ

Low-dose NE ๋‹จ๊ณ„์—์„œ early vasopressin์„ ์“ฐ๋ฉด mortality ๊ฐœ์„  ํšจ๊ณผ๊ฐ€ ์žˆ๋‹ค๊ณ  ์ •๋ฆฌ๋˜์–ด ์žˆ๋‹ค. ๊ฐ๋Ÿ‰ ์‹œ์—๋Š” NE๋ฅผ ๋จผ์ € ์„œ์„œํžˆ taperingํ•˜๊ณ  ์•ˆ์ •์ ์ด๋ฉด vasopressin๋„ ๊ฐ™์ด ๊ฐ๋Ÿ‰ํ•œ๋‹ค.

์ถœ์ฒ˜

Surviving Sepsis Campaign.

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