• Best Pract Res Clin Anaesthesiol · Dec 2016

    Review

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

    • M Hessler, T G Kampmeier, and S Rehberg.
    • 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.
    • Best Pract Res Clin Anaesthesiol. 2016 Dec 1; 30 (4): 465-477.

    AbstractThe 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.Copyright © 2016 Elsevier Ltd. All rights reserved.

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