Thirst perception and osmoregulation of vasopressin secretion are altered during recovery from septic shock.

<h4>Objective</h4>Vasopressin (AVP) secretion during an osmotic challenge is frequently altered in the immediate post-acute phase of septic shock. We sought to determine if this response is still altered in patients recovering from septic shock.<h4>Design</h4>Prospective inte...

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Autores principales: Shidasp Siami, Andrea Polito, Raphael Porcher, Tarik Hissem, Anne Blanchard, Catherine Boucly, Robert Carlier, Djillali Annane, Jean-Philippe Haymann, Tarek Sharshar
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Publicado: Public Library of Science (PLoS) 2013
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spelling oai:doaj.org-article:459b8aa79f6741c88b94e9af73eeeb6a2021-11-18T08:48:00ZThirst perception and osmoregulation of vasopressin secretion are altered during recovery from septic shock.1932-620310.1371/journal.pone.0080190https://doaj.org/article/459b8aa79f6741c88b94e9af73eeeb6a2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24223220/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>Vasopressin (AVP) secretion during an osmotic challenge is frequently altered in the immediate post-acute phase of septic shock. We sought to determine if this response is still altered in patients recovering from septic shock.<h4>Design</h4>Prospective interventional study.<h4>Setting</h4>Intensive care unit (ICU) at Raymond Poincaré and Etampes Hospitals.<h4>Patients</h4>Normonatremic patients at least 5 days post discontinuation of catecholamines given for a septic shock.<h4>Intervention</h4>Osmotic challenge involved infusing 500 mL of hypertonic saline solution (with cumulative amount of sodium not exceeding 24 g) over 120 minutes.<h4>Measurements and main results</h4>Plasma AVP levels were measured 15 minutes before the infusion and then every 30 minutes for two hours. Non-responders were defined as those with a slope of the relation between AVP and plasma sodium levels less than < 0.5 ng/mEq. Among the 30 included patients, 18 (60%) were non-responders. Blood pressure and plasma sodium and brain natriuretic peptide levels were similar in both responders and non-responders during the course of the test. Critical illness severity, hemodynamic alteration, electrolyte disturbances, treatment and outcome did not differ between the two groups. Responders had more severe gas exchange abnormality. Thirst perception was significantly diminished in non-responders. The osmotic challenge was repeated in 4 non-responders several months after discharge and the abnormal response persisted.<h4>Conclusion</h4>More than half of patients recovering from septic shock have an alteration of osmoregulation characterised by a dramatic decrease in vasopressin secretion and thirst perception during osmotic challenge. The mechanisms of this alteration but also of the relationship between haematosis and normal response remain to be elucidated.Shidasp SiamiAndrea PolitoRaphael PorcherTarik HissemAnne BlanchardCatherine BouclyRobert CarlierDjillali AnnaneJean-Philippe HaymannTarek SharsharPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 11, p e80190 (2013)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Shidasp Siami
Andrea Polito
Raphael Porcher
Tarik Hissem
Anne Blanchard
Catherine Boucly
Robert Carlier
Djillali Annane
Jean-Philippe Haymann
Tarek Sharshar
Thirst perception and osmoregulation of vasopressin secretion are altered during recovery from septic shock.
description <h4>Objective</h4>Vasopressin (AVP) secretion during an osmotic challenge is frequently altered in the immediate post-acute phase of septic shock. We sought to determine if this response is still altered in patients recovering from septic shock.<h4>Design</h4>Prospective interventional study.<h4>Setting</h4>Intensive care unit (ICU) at Raymond Poincaré and Etampes Hospitals.<h4>Patients</h4>Normonatremic patients at least 5 days post discontinuation of catecholamines given for a septic shock.<h4>Intervention</h4>Osmotic challenge involved infusing 500 mL of hypertonic saline solution (with cumulative amount of sodium not exceeding 24 g) over 120 minutes.<h4>Measurements and main results</h4>Plasma AVP levels were measured 15 minutes before the infusion and then every 30 minutes for two hours. Non-responders were defined as those with a slope of the relation between AVP and plasma sodium levels less than < 0.5 ng/mEq. Among the 30 included patients, 18 (60%) were non-responders. Blood pressure and plasma sodium and brain natriuretic peptide levels were similar in both responders and non-responders during the course of the test. Critical illness severity, hemodynamic alteration, electrolyte disturbances, treatment and outcome did not differ between the two groups. Responders had more severe gas exchange abnormality. Thirst perception was significantly diminished in non-responders. The osmotic challenge was repeated in 4 non-responders several months after discharge and the abnormal response persisted.<h4>Conclusion</h4>More than half of patients recovering from septic shock have an alteration of osmoregulation characterised by a dramatic decrease in vasopressin secretion and thirst perception during osmotic challenge. The mechanisms of this alteration but also of the relationship between haematosis and normal response remain to be elucidated.
format article
author Shidasp Siami
Andrea Polito
Raphael Porcher
Tarik Hissem
Anne Blanchard
Catherine Boucly
Robert Carlier
Djillali Annane
Jean-Philippe Haymann
Tarek Sharshar
author_facet Shidasp Siami
Andrea Polito
Raphael Porcher
Tarik Hissem
Anne Blanchard
Catherine Boucly
Robert Carlier
Djillali Annane
Jean-Philippe Haymann
Tarek Sharshar
author_sort Shidasp Siami
title Thirst perception and osmoregulation of vasopressin secretion are altered during recovery from septic shock.
title_short Thirst perception and osmoregulation of vasopressin secretion are altered during recovery from septic shock.
title_full Thirst perception and osmoregulation of vasopressin secretion are altered during recovery from septic shock.
title_fullStr Thirst perception and osmoregulation of vasopressin secretion are altered during recovery from septic shock.
title_full_unstemmed Thirst perception and osmoregulation of vasopressin secretion are altered during recovery from septic shock.
title_sort thirst perception and osmoregulation of vasopressin secretion are altered during recovery from septic shock.
publisher Public Library of Science (PLoS)
publishDate 2013
url https://doaj.org/article/459b8aa79f6741c88b94e9af73eeeb6a
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