Terlipressin Infusion in Catecholamine-resistant Shock

Jolley, Daniel; Keulenaer, Bart L. De; Potter, A.; Stephens, Dianne P.

doi:10.1177/0310057x0303100532

Cited by 19 publications

(4 citation statements)

References 22 publications

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“…Plasma levels of lysine vasopressin increase 40 to 60 minutes after bolus injection of terlipressin, peaking at 60 to 120 minutes after administration (70-100 pmol/L) [ 11 , 12 ]. In recent years, several studies investigated the feasibility of continuous terlipressin infusion in both the experimental [13][14][15] and clinical settings [16][17][18]. Unfortunately, no pharmacokinetic data are available on the latter approach.…”

Section: Physiology and Pharmacology Of Arginine Vasopressin And Terlmentioning

confidence: 99%

Current place of vasopressin analogues in the treatment of septic shock

Ertmer

Rehberg²,

Morelli³

et al. 2008

Curr Infect Dis Rep

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Arginine vasopressin and terlipressin increase mean arterial pressure and reduce catecholamine requirements in septic shock patients. Infusing either agent may reduce incidence of new-onset tachyarrhythmias and improve renal function. The recent Vasopressin and Septic Shock Trial did not demonstrate an overall survival benefit of arginine vasopressin infusion (0.03 U/min) compared with norepinephrine (15 microg/min). However, patients with less severe septic shock (ie, < 15 microg/min of norepinephrine) at arginine vasopressin initiation had a lower 28-day mortality rate compared with norepinephrine-only infusion (26.5% vs 35.7%; P = 0.05). An unpublished study comparing terlipressin (1.3 microg/kg/h), arginine vasopressin (0.03 U/min), and norepinephrine (15 microg/min) as first-line vasopressors showed that terlipressin had higher efficacy than arginine vasopressin in reducing catecholamine requirements. Current literature suggests that early infusion of low-dose continuous arginine vasopressin or terlipressin appears superior to a last-resort treatment. However, because no large clinical trials have proven terlipressin's safety in patients with septic shock, arginine vasopressin is preferred until more data are available.

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Section: Physiology and Pharmacology Of Arginine Vasopressin And Terlmentioning

confidence: 99%

Current place of vasopressin analogues in the treatment of septic shock

Ertmer

Rehberg²,

Morelli³

et al. 2008

Curr Infect Dis Rep

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“…However, the patients treated with TP as first-line vasopressor survived and showed no signs of TP-related AEs. Taken together, with results from experimental studies (Asfar et al, 2005;Lange et al, 2007) and previous clinical case reports (Jolley et al, 2003;Zeballos et al, 2006), early low-dose infusion of TP may potentially be superior to a later resort strategy in septic shock. Recently, Xiao et al (2016) reported that low dose of TP continuous infusion combined with NE has synergistic effect in septic shock patients.…”

Section: The Significance Of This Study For Future Clinical Practice mentioning

confidence: 59%

Terlipressin Versus Norepinephrine for Septic Shock: A Systematic Review and Meta-Analysis

Huang

Guo

et al. 2019

Front. Pharmacol.

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Purpose: The meta-analysis aims to evaluate the efficacy and safety of terlipressin compared with norepinephrine for septic shock. Materials and Methods:The relevant studies from MEDLINE, Cochrane Library, Embase were searched by two independent investigators. A variety of keywords were used to search the studies. Stata software (version 11.0, Stata Corp LP, College Station, TX, USA) was used for statistical analysis.Results: A total of six studies were identified and incorporated into the meta-analysis. The results showed that there was no difference for 28-day mortality (RR = 0.99, 95% CI = [0.85,1.15], P = 0.849), AE (RR = 2.54, 95% CI = [0.58,11.08], P = 0.214), and MAP (SMD = -0.10, 95% CI = [-0.35,0.14], P = 0.405), OI, urinary output, Scr, total bilirubin, ALT, and AST between TP group and NE group. While TP could decrease HR at 24 and 48 h compared with NE.Conclusions: Current results suggest that terlipressin showed no added survival benefit for septic shock when compared with norepinephrine, while terlipressin could decrease heart rate in the late phase of septic shock compared with norepinephrine without further liver and kidney injury.Systematic Review Registration: PROSPERO (ID: CRD42019128743). Available online at: http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42019128743.

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“…Die verwendeten AVP-Dosierungen reichen von 0,0 U*min − bis zu ,8 U*min − [28,32]; bei Anwendung von TP wurden entweder repetitive Bolusinjektionen von weniger als  mg [4] bis zu 2 mg [43] oder eine kontinuierliche Infusion von 250-500 µg*h − appliziert [26] Da es bisher keine prospektiven, placebokontrollierten Studien, sondern nur Fallberichte zur TP-Anwendung bei Sepsis und SIRS gibt, sind wertende Aussagen über die Wirkungen von TP bei Hypotonie im Rahmen systemischer Entzün-dungsreaktionen schwierig. Bisherige Erfahrungen zeigen jedoch, dass auch TP die Vasodilatation antagonisieren und somit den MAD stabilisieren kann [26,40,43], so dass ein erleichtertes Ausschleichen konventioneller Vasopressoren mög-lich ist [43]. Die Blutdrucksteigerung geht allerdings sowohl in den klinischen Studien als auch in den tierexperimentellen Untersuchungen regelmäßig mit einer deutlichen Reduktion von HZV und HF einher [26,40,43,70].…”

Section: Bisherige Erfahrungen Bei Septischen Patientenunclassified

“…Bisherige Erfahrungen zeigen jedoch, dass auch TP die Vasodilatation antagonisieren und somit den MAD stabilisieren kann [26,40,43], so dass ein erleichtertes Ausschleichen konventioneller Vasopressoren mög-lich ist [43]. Die Blutdrucksteigerung geht allerdings sowohl in den klinischen Studien als auch in den tierexperimentellen Untersuchungen regelmäßig mit einer deutlichen Reduktion von HZV und HF einher [26,40,43,70].…”

Section: Bisherige Erfahrungen Bei Septischen Patientenunclassified

Einsatz von Vasopressin und Terlipressin bei Sepsis und systemischen Entzündungsreaktionen

et al. 2005

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Vasopressin and terlipressin are increasingly used as alternative non-adrenergic vasopressors for hemodynamic support of septic patients with arterial hypotension. Despite excellent vasopressive effects, vasopressin analogues may potentially impair macro-hemodynamics, oxygen transport and microvascular blood flow. Due to those unwanted side-effects, vasopressin and terlipressin may potentially compromise organ function and possibly foster the development of multiple organ failure. This review article discusses the results of clinical and experimental studies to judge the effects of vasopressin and terlipressin on microcirculation, oxygen supply, metabolism and organ function in patients with sepsis or systemic inflammatory response syndrome (SIRS). Although vasopressin analogues are emerging as promising alternatives to treat catecholamine-refractory hypotension, there is no evidence that vasopressin receptor agonists improve outcome. To date, vasopressin and terlipressin can, therefore, not be recommended for routine clinical use.

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Terlipressin Infusion in Catecholamine-resistant Shock

Cited by 19 publications

References 22 publications

Current place of vasopressin analogues in the treatment of septic shock

Current place of vasopressin analogues in the treatment of septic shock

Terlipressin Versus Norepinephrine for Septic Shock: A Systematic Review and Meta-Analysis

Einsatz von Vasopressin und Terlipressin bei Sepsis und systemischen Entzündungsreaktionen

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