Division of Critical Care Medicine, Centre for Heart Lung Innovation, University of British Columbia, 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada.
Division of Critical Care Medicine, Centre for Heart Lung Innovation, University of British Columbia, 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada.
Crit Care Clin. 2019 Apr;35(2):247-261. doi: 10.1016/j.ccc.2018.11.004. Epub 2019 Jan 23.
Vasodilatory shock is the final common pathway for all forms of severe shock, with sepsis the most common primary etiology and the leading cause of critical illness-related mortality. The pathophysiology of this condition remains incompletely elucidated. Deficiency of the neuropeptide hormone vasopressin seems to play a significant role. The physiology of vasopressin and its interaction with the pathophysiology of vasodilatory shock are described in this review. A brief review of the major randomized controlled trials assessing the efficacy and safety of vasopressin and its analogs in this complex patient cohort is also provided.
血管扩张性休克是所有严重休克形式的共同终末途径,其中脓毒症是最常见的原发性病因,也是导致与危重病相关死亡的主要原因。这种情况的病理生理学仍不完全清楚。神经肽激素血管升压素的缺乏似乎起着重要作用。本文综述了血管升压素的生理学及其与血管扩张性休克病理生理学的相互作用。本文还简要回顾了评估血管升压素及其类似物在这一复杂患者群体中的疗效和安全性的主要随机对照试验。