* mews score \> 4 * severe multiple organ failure * recent cardiomyopathy, unstable angina, acute myocardial infarction * severe kidney failure with glomerular filtration rate less than 30 ml/min or renal replacement therapy or peritoneal dialysis * history of diabetes insipidus or severe hyponatremia (\<128 meq/l) or hypernatremia (\>155 meq/l) * qt interval which in the opinion of the patient's treating physician contraindicates therapy with ot * state of shock * women who are pregnant or nursing * known intolerance or hypersensitivity to the drug or its excipients * treatment with antirejection agents * individuals with severe liver failure * patients enrolled in other clinical trials

* mews score \> 4 * severe multiple organ failure * recent cardiomyopathy, unstable angina, acute myocardial infarction * severe kidney failure with glomerular filtration rate less than 30 ml/min or renal replacement therapy or peritoneal dialysis * history of diabetes insipidus or severe hyponatremia (\<128 meq/l) or hypernatremia (\>155 meq/l) * qt interval which in the opinion of the patient's treating physician contraindicates therapy with ot * state of shock * women who are pregnant or nursing * known intolerance or hypersensitivity to the drug or its excipients * treatment with antirejection agents * individuals with severe liver failure * patients enrolled in other clinical trials

- mews score > 4 - severe multiple organ failure - recent cardiomyopathy, unstable angina, acute myocardial infarction - severe kidney failure with glomerular filtration rate less than 30 ml/min or renal replacement therapy or peritoneal dialysis - history of diabetes insipidus or severe hyponatremia (<128 meq/l) or hypernatremia (>155 meq/l) - qt interval which in the opinion of the patient's treating physician contraindicates therapy with ot - state of shock - women who are pregnant or nursing - known intolerance or hypersensitivity to the drug or its excipients - treatment with antirejection agents - individuals with severe liver failure - patients enrolled in other clinical trials

- mews score > 4 - severe multiple organ failure - recent cardiomyopathy, unstable angina, acute myocardial infarction - severe kidney failure with glomerular filtration rate less than 30 ml/min or renal replacement therapy or peritoneal dialysis - history of diabetes insipidus or severe hyponatremia (<128 meq/l) or hypernatremia (>155 meq/l) - qt interval which in the opinion of the patient's treating physician contraindicates therapy with ot - state of shock - women who are pregnant or nursing - known intolerance or hypersensitivity to the drug or its excipients - treatment with antirejection agents - individuals with severe liver failure - patients enrolled in other clinical trials