Intensive Care Medicine

, Volume 34, Issue 3, pp 511–517

Terlipressin as a rescue therapy for catecholamine-resistant septic shock in children

  • Dincer Yildizdas
  • Hacer Yapicioglu
  • Umit Celik
  • Yasar Sertdemir
  • Emre Alhan
Pediatric Original

DOI: 10.1007/s00134-007-0971-x

Cite this article as:
Yildizdas, D., Yapicioglu, H., Celik, U. et al. Intensive Care Med (2008) 34: 511. doi:10.1007/s00134-007-0971-x

Abstract

Objective

To evaluate the effect of terlipressin on oxygenation, PaO2/FIO2, heart rate, mean arterial pressure, and mortality in children with septic shock refractory to high doses of dopamine/dobutamine and adrenaline.

Design and setting

A randomized, nonblind study in the pediatric intensive care unit of a university hospital.

Patients and measurements

We studied 58 children with septic shock and refractory hypotension despite fluid loading and high doses of catecholamines, randomly enrolled to terlipressin (TP, n = 30) or control (n = 28). TP was administered as intravenous bolus doses of 20 μg/kg every 6 h for a maximum of 96 h. Hemodynamic changes, PaO2/FIO2 rates, length of stay, and mortality rate in PICU were recorded prospectively.

Results

Mean arterial pressure and PaO2/FIO2 significantly increased, and heart rate significantly decreased 30 min after each TP treatment, but mortality did not differ from control (67.3% vs. 71.4%). Mean stay in the PICU was shorter in the TP group (13.4 ± 7.9 vs. 20.2 ± 9.7 days and was longer among nonsurvivors of the TP group vs. control (10.4 ± 6.9 vs. 6.2 ± 3.4 days). Blood urea nitrogen, creatinine, AST, ALT, and urine output of patients in the TP group did not change after terlipressin.

Conclusions

Although terlipressin infusion had no effect on mortality, it significantly increases mean arterial pressure, PaO2/FIO2, and survival time in nonsurvivors. Terlipressin seems to cause no adverse effect but warrants further evaluation as a rescue therapy in refractory septic shock.

Keywords

TerlipressinEpinephrineSeptic shockChildren

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Dincer Yildizdas
    • 1
  • Hacer Yapicioglu
    • 2
  • Umit Celik
    • 3
  • Yasar Sertdemir
    • 4
  • Emre Alhan
    • 3
  1. 1.Faculty of Medicine, Department of Pediatrics, Division of Intensive Care UnitÇukurova UniversityAdanaTurkey
  2. 2.Faculty of Medicine, Department of Pediatrics, Division of NeonatologyÇukurova UniversityAdanaTurkey
  3. 3.Faculty of Medicine, Department of Pediatrics, Division of Infectious DiseaseÇukurova UniversityAdanaTurkey
  4. 4.Faculty of Medicine, Department of BiostatisticsÇukurova UniversityAdanaTurkey