Josefine Thomsen & Ulrik Sprogøe:
Complete tachyphylaxis for vasopressin in a patient with subarachnoid haemorrhage
Ugeskr Læger 2019;181:V01180050
In this case report, we present a 28-year-old woman who was admitted to a neuro-intensive care unit with subarachnoid haemorrhage. She was intubated and haemodynamically unstable. Over five days the need for norepinephrine reached the level of 1.2 µg/kg/min to insure a sufficient cerebral perfusion pressure. Epinephrine and vasopressin were without effect in raising the blood pressure. On suspicion of tachyphylaxis the norepinephrine infusion was stopped, and no decline in blood pressure was observed. After two days without use of any vasopressor agents, the efficacy of norepinephrine returned to normal.