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Crit Care. 2018 Jan 19;22(1):10. doi: 10.1186/s13054-018-1942-z.

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

Author information

1
Division of Intensive Care Units, Department of Medicine, Université de Sherbrooke, 3001 - 12e Avenue Nord, Sherbrooke, QC, J1H 5 N4, Canada.
2
Division of Cardiology, Department of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada.
3
Pharmacology Institute of Sherbrooke, Faculty of Medecine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada.
4
Department of Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, Québec, Canada.
5
Division of Intensive Care Units, Department of Medicine, Université de Sherbrooke, 3001 - 12e Avenue Nord, Sherbrooke, QC, J1H 5 N4, Canada. Olivier.Lesur@USherbrooke.ca.
6
Pharmacology Institute of Sherbrooke, Faculty of Medecine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada. Olivier.Lesur@USherbrooke.ca.

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.

KEYWORDS:

Apelin (APJ) receptor; Apelinergic system; Biased signaling; Decatecholaminization; Inodilator; Septic shock

PMID:
29347994
PMCID:
PMC5774146
DOI:
10.1186/s13054-018-1942-z
[Indexed for MEDLINE]
Free PMC Article

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