Vasopressin analogues and V1a receptor agonists in septic shock.

This article reviews the role of arginine-vasopressin and the vasopressin analogue terlipressin as potent alternative vasoconstrictors in the treatment of fluid and catecholamine-refractory septic shock. Terlipressin is the most selective, clinically available V1 receptor agonist, and may be more potent than arginine-vasopressin in restoring catecholamine refractory septic shock. Recent experimental and clinical studies on terlipressin, as well as the possible benefit of selective V1a receptor agonists, are discussed.