?? Paper of the day

?? Paper of the day

Vascular leak in sepsis: physiological basis and potential therapeutic advances

Published in Critical Care

https://ccforum.biomedcentral.com/articles/10.1186/s13054-024-04875-6

Summary:

The article discusses the physiological basis and potential therapeutic advances in vascular leak in sepsis, focusing on endothelial barrier dysfunction and impairment of microcirculatory function. It explores key mechanisms and potential therapeutic agents relevant to endothelial barrier function.

Key takeaways:

1. Sepsis is a life-threatening condition characterized by endothelial barrier dysfunction and impairment of normal microcirculatory function, resulting in hypoperfusion and tissue edema.

2. Endothelial breakdown and microcirculatory dysfunction play a prominent role in sepsis, and there is a need for effective strategies to protect the endothelium.

3. Therapeutic approaches such as tyrosine kinase inhibitors, selective vasopressin V1a receptor agonists, mesenchymal stromal cells, statins, and PCSK-9 inhibitors are being explored for their potential in preserving and restoring endothelial function in sepsis.

Counter arguments:

1. Despite promising preclinical evidence, the clinical efficacy of some therapeutic approaches, such as vasopressin receptor agonists and mesenchymal stromal cell therapy, has not been consistently demonstrated in clinical trials.

2. The benefits of statin therapy in patients with sepsis, particularly in terms of survival, have shown variability in different studies.

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