感染性休克
医学
重症监护医学
加压素
去甲肾上腺素
败血症
复苏
休克(循环)
兴奋剂
不利影响
重症监护室
心理干预
药理学
麻醉
生物信息学
受体
内科学
生物
精神科
多巴胺
作者
Elio Antonucci,Manuela Giovini,Sara Agosta,Yasser Sakr,Marc Léone
出处
期刊:Shock
[Ovid Technologies (Wolters Kluwer)]
日期:2022-06-01
卷期号:57 (6): 172-179
被引量:5
标识
DOI:10.1097/shk.0000000000001932
摘要
Sepsis and septic shock usually show a high mortality rate and frequently need of intensive care unit admissions. After fluid resuscitation, norepinephrine (NE) is the first-choice vasopressor in septic shock patients. However, high-NE doses are associated with increased rates of adverse effects and mortality. In this perspective, many authors have proposed the administration of non-adrenergic vasopressors (NAV). Selepressin is a selective vasopressin type 1A (V1A) receptor agonist and may be a valid option in this field, because it can decrease NE requirements and also limit the deleterious effects induced by high doses of catecholamines. Only few clinical data actually support selepressin administration in this setting. Here, we review the current literature on this topic analyzing some pathophysiological aspects, the rationale about the use of NAV, the possible use of selepressin differentiating animal, and human studies. Various issues remain unresolved and future trials should be focused on early interventions based on a multimodal activation of the vasopressive pathways using both alpha and V1A receptors pathways.
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