VASOPRESSIN IN CARDIOGENIC SHOCK: PATHOPHYSIOLOGY, CLINICAL EVIDENCE, AND THERAPEUTIC PERSPECTIVES

Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS; Berne Cardiovascular Research Center, University of Virginia; Department of Cardiovascular and Respiratory Sciences, Catholic University of the Sacred Heart

Vasopressin is a non-adrenergic vasopressor commonly used in distributive shock, which may offer therapeutic benefits in selected phenotypes of cardiogenic shock. The review discusses the pharmacologic mechanisms and haemodynamic effects of vasopressin, emphasizing its potential advantages in advanced or mixed cardiogenic shock with low systemic vascular resistance. Additionally, it outlines clinical scenarios where vasopressin may be harmful and stresses the need for prospective studies to optimize vasopressor selection in this high-risk population.