The Role of Vasopressin and the Vasopressin Type V1a Receptor Agonist Selepressin in Septic Shock

感染性休克仍然是危重病人发病和死亡的主要原因之一。尽管进行了早期目标治疗并给予了链胆胺能药物，但仍有高达30%的患者死于该疾病。在这份手稿中，我们首先总结了感染性休克患者的护理标准和当前的指南。我们回顾了加压素的生理作用及其在脓毒性休克管理中的作用。然后，我们回顾了关于V1a受体激动剂(如加压素)在感染性休克中潜在作用的最新证据。令人兴奋的新试验正在完成，以阐明V1a受体激动剂作为潜在的一线血管加压药替代品在脓毒症患者循环休克治疗中的作用。Septic shock remains one of the major causes of morbidity and mortality in the critically ill. Despite early goal therapy and administration of cathecholaminergic agents, up to 30% of patients succumb to the disease. In this manuscript, we first summarize the standard of care of patients with septic shock and current guidelines. We review the physiologic role of vasopressin and its role in septic shock management. We then review the most up-to-date evidence on the potential role of V1a receptor agonists such as Selepressin, in septic shock. Exciting new trials are being completed in order to elucidate the role of V1a receptor agonists as potential first-line vasopressor alternatives in the therapy of circulatory shock in septic patients.