Effect of non-adrenergic vasopressors on macro- and microvascular coupling in distributive shock. Issue 4 (December 2016)

• Record Type: Journal Article
• Authors: Hessler, M.; Kampmeier, T.G.; Rehberg, S.
• Is Part Of: Best practice & research. Volume 30:Issue 4(2016)
• Page Start: 465
• Page End: 477
• Publication Date: 2016-12
• Subjects: arginine vasopressin -- hemodynamic coherence -- microcirculation -- selepressin -- septic shock -- terlipressin -- vasoplegic shock; Anesthesiology -- Periodicals; Anesthesia -- Periodicals; Anesthesia -- Periodicals; Anesthetics -- Periodicals; Anesthesia; Anesthesiology; Periodicals; 617.9605
• DOI: 10.1016/j.bpa.2016.10.010
• Languages: English
• ISSNs: 1521-6869

Abstract

Abstract : The present review initially describes the rationale for the use of non-adrenergic vasopressors in the treatment of distributive shock and then provides an overview of the individual vasopressin-receptor agonists, namely arginine vasopressin, terlipressin, and selepressin. Following a brief summary of their current use in clinical practice, the present review focuses on the influence of vasopressin-receptor agonists on macro- and microvascular coupling, also referred to as hemodynamic coherence. On the basis of the current evidence from experimental and clinical studies, vasopressin-receptor agonists do not negatively influence macro- and microvascular coupling as compared to the standard therapy with norepinephrine, when used in established treatment regimes. A higher selectivity for the V1a -receptor seems to be beneficial; however, future clinical trials are warranted to verify this assumption. Notably, the optimal treatment regime for non-adrenergic vasopressors with respect to compound, dose, and timing still needs to be defined.