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01.12.2018 | Viewpoint | Ausgabe 1/2018 Open Access

Critical Care 1/2018

The apelinergic system as an alternative to catecholamines in low-output septic shock

Zeitschrift:
Critical Care > Ausgabe 1/2018
Autoren:
David Coquerel, Xavier Sainsily, Lauralyne Dumont, Philippe Sarret, Éric Marsault, Mannix Auger-Messier, Olivier Lesur

Abstract

Catecholamines, in concert with fluid resuscitation, have long been recommended in the management of septic shock. However, not all patients respond positively and controversy surrounding the efficacy-to-safety profile of catecholamines has emerged, trending toward decatecholaminization. Contextually, it is time to re-examine the “maintaining blood pressure” paradigm by identifying safer and life-saving alternatives. We put in perspective the emerging and growing knowledge on a promising alternative avenue: the apelinergic system. This target exhibits invaluable pleiotropic properties, including inodilator activity, cardio-renal protection, and control of fluid homeostasis. Taken together, its effects are expected to be greatly beneficial for patients in septic shock.
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