Effect of non-adrenergic vasopressors on macro- and microvascular coupling in distributive shock

Hessler M, Kampmeier TG, Rehberg S

Research article (journal) | Peer reviewed

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 V-1a-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. (C) 2016 Elsevier Ltd. All rights reserved.

Details about the publication

JournalBest Practice and Research: Clinical Anaesthesiology
Volume30
Issue4
Page range465-477
StatusPublished
Release year2016
Language in which the publication is writtenEnglish
DOI10.1016/j.bpa.2016.10.010
Keywordsarginine vasopressin; hemodynamic coherence; microcirculation; selepressin; septic shock; terlipressin; vasoplegic shock

Authors from the University of Münster

Heßler, Michael
Clinic for Anaesthesiology, Surgical Critical Care Medicine and Pain Therapy
Kampmeier, Tim-Gerald
Clinic for Anaesthesiology, Surgical Critical Care Medicine and Pain Therapy
Rehberg, Sebastian
Clinic for Anaesthesiology, Surgical Critical Care Medicine and Pain Therapy