title: Effect of non-adrenergic vasopressors on macro- and microvascular coupling in distributive shock.
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.
authors.affiliation: Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital of Muenster, Albert-Schweitzer-Campus 1, Bldg. A1, 48149, Muenster, Germany. Electronic address: michael.hessler@uni-muenster.de.
authors.forename: M
authors.initials: M
authors.lastname: Hessler
authors.affiliation: Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital of Muenster, Albert-Schweitzer-Campus 1, Bldg. A1, 48149, Muenster, Germany. Electronic address: kampmeier@uni-muenster.de.
authors.forename: T G
authors.initials: TG
authors.lastname: Kampmeier
authors.affiliation: Department of Anaesthesiology, University Hospital of Greifswald, Greifswald, Germany. Electronic address: Sebastian.Rehberg@uni-greifswald.de.
authors.forename: S
authors.initials: S
authors.lastname: Rehberg
mesh_terms: D018663:Adrenergic Agents / Q000494:pharmacology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008833:Microcirculation / Q000187:drug effects*; D017483:Receptors, Vasopressin / Q000819:agonists; D012772:Shock, Septic / Q000188:drug therapy / Q000503:physiopathology; D014662:Vasoconstrictor Agents / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D018663:Adrenergic Agents; D017483:Receptors, Vasopressin; D014662:Vasoconstrictor Agents
keywords: arginine vasopressin; hemodynamic coherence; microcirculation; selepressin; septic shock; terlipressin; vasoplegic shock