, Volume 33, Issue 9, pp 1669-1670
Date: 25 May 2007

Continuous terlipressin infusion in patients with septic shock: less may be best, and the earlier the better?

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Bolus infusion of terlipressin (TP) may contribute to an overshooting vasoconstrictive response that is typically linked to a significant decrease in systemic blood flow and global oxygen transport, thereby limiting its clinical applicability in sepsis [13].

In three septic shock patients requiring adrenergic vasopressor support to maintain mean arterial pressure (MAP) between 65 and 75 mmHg despite adequate volume resuscitation, we investigated the use of two different TP doses, i. e. 2.6 μg/kg/h (low dose) and 1.3 μg/kg/h (ultra-low dose) over a treatment period of 48 h. Norepinephrine (NE) was addition ally infused if the target MAP was not achieved with TP infusion alone.

Patient A was a 44-year-old woman suffering from septic shock due to peritonitis and complicated by acute respiratory distress syndrome receiving 1.1 μg/kg/min NE for hemodynamic support. In the ICU, continuous infusion of TP (2.6 μg/kg/h) was started.

Patient B was a 71-year-old man patient in septic shock due to a ...

This study was performed in the Intensive Care Unit of the Department of Anesthesiology and Intensive Care of the University of Rome “La Sapienza” and funded by an independent research grant from the Department of Anesthesiology and Intensive Care of the University of Rome “La Sapienza”.