We have located links that may give you full text access.
Journal Article
Research Support, Non-U.S. Gov't
Short-term effects of terlipressin bolus infusion on sublingual microcirculatory blood flow during septic shock.
Intensive Care Medicine 2011 June
PURPOSE: Terlipressin bolus infusion may contribute to overshooting increases in systemic vascular resistance with concomitant reductions in systemic blood flow and oxygen delivery. Whether these effects negatively impact on microcirculatory perfusion is still not known. The objective of the present study was, therefore, to elucidate the effects of a single terlipressin bolus dose of 0.5 mg on microcirculatory perfusion in patients with catecholamine-dependent septic shock.
METHODS: This prospective clinical cohort study was performed in a multidisciplinary intensive care unit at a university hospital. We enrolled 20 patients suffering from catecholamine-dependent septic shock. After restoring normovolaemia, norepinephrine (NE) was titrated to maintain mean arterial pressure (MAP) between 65 and 75 mmHg. Thereafter, all patients received a bolus infusion of 0.5 mg terlipressin, and NE was adjusted to maintain MAP between the threshold values. Sublingual microcirculatory blood flow of small vessels was assessed by sidestream dark-field imaging. All measurements, including data from right heart catheterization and NE requirements, were obtained at baseline and 6 h after terlipressin administration.
RESULTS: Terlipressin stabilized haemodynamics and, at the same time, decreased NE requirements (0.42 ± 0.67 vs. 0.74 ± 0.73 μg/kg per minute, p<0.05). Whereas the pH and arterial lactate concentrations remained unchanged, microcirculatory flow index of small vessels had increased at the end of the 6-h study period (2.6 ± 0.6 vs. 2.0 ± 0.5 units, p<0.05).
CONCLUSION: In fluid-resuscitated patients with septic shock (with a MAP between 65 and 75 mmHg), a bolus infusion of 0.5 mg terlipressin was effective in reducing NE requirements without worsening microcirculatory blood flow. Randomized clinical trials are now warranted to verify these preliminary results.
METHODS: This prospective clinical cohort study was performed in a multidisciplinary intensive care unit at a university hospital. We enrolled 20 patients suffering from catecholamine-dependent septic shock. After restoring normovolaemia, norepinephrine (NE) was titrated to maintain mean arterial pressure (MAP) between 65 and 75 mmHg. Thereafter, all patients received a bolus infusion of 0.5 mg terlipressin, and NE was adjusted to maintain MAP between the threshold values. Sublingual microcirculatory blood flow of small vessels was assessed by sidestream dark-field imaging. All measurements, including data from right heart catheterization and NE requirements, were obtained at baseline and 6 h after terlipressin administration.
RESULTS: Terlipressin stabilized haemodynamics and, at the same time, decreased NE requirements (0.42 ± 0.67 vs. 0.74 ± 0.73 μg/kg per minute, p<0.05). Whereas the pH and arterial lactate concentrations remained unchanged, microcirculatory flow index of small vessels had increased at the end of the 6-h study period (2.6 ± 0.6 vs. 2.0 ± 0.5 units, p<0.05).
CONCLUSION: In fluid-resuscitated patients with septic shock (with a MAP between 65 and 75 mmHg), a bolus infusion of 0.5 mg terlipressin was effective in reducing NE requirements without worsening microcirculatory blood flow. Randomized clinical trials are now warranted to verify these preliminary results.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app