Abstract

Hypovolemic shock is a life-threatening condition with high mortality, requiring urgent resuscitative therapy to restore perfusion and prevent irreversible organ damage alongside the definitive management. Current treatments, including fluid resuscitation with initially crystalloids and later blood or its components followed by vasopressors have certain limitations in effectively restoring hemodynamics and improving tissue perfusion besides some safety concerns. This review explores unique features of a novel first-in-class resuscitative agent centhaquine including unique mechanism of action, pure venoconstriction without arterial constriction and wide safety margin. The balanced modulation of venous return and arterial resistance allows centhaquine to increase cardiac output in patients with hypovolemic shock while maintaining the tissue perfusion without compromising microcirculatory flow, offering clinicians a more effective option to improve survival in these critically ill patients. Preclinical and clinical studies demonstrate that centhaquine significantly improves hemodynamic parameters, reduces vasopressor and fluid requirements, lowers blood lactate levels and improves survival in patients with hypovolemic shock. Centhaquine’s renoprotective effects further highlight its potential in preventing organ failure following hypovolemic shock. The safety profile of centhaquine has been established across multiple phases of clinical trials and it is currently approved in India for the treatment of hypovolemic shock. Centhaquine represents a promising advancement in the management of shock, offering a novel approach to improving patient outcomes. Further research could evaluate the potential of centhaquine in managing other forms of shock such as neurogenic shock and septic shock

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