Skip to main content
SpringerLink
Log in

Vasopressin vs. terlipressinin the treatmentof cardiovascular failure in sepsis

  • Review
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

Background

Arginine vasopressin (AVP) and terlipressin (TP) are increasingly used as adjunct vasopressors in the treatment of septic shock. Despite important pharmacological differences between the two drugs (e.g., receptor selectivity, effective half-life) the use of either substance is determined mainly by local availability and institutional inventory. We briefly describe the pathophysiology and pharmacology of septic shock relevant to the treatment with vasopressin analogues. In addition, differences in pharmacokinetics and pharmacodynamics between AVP and TP are discussed.

Discussion

The current literature suggests that neither AVP nor TP should be administered in high doses in patients with septic shock. Furthermore, increasing evidence indicates that early administration of vasopressin analogues may improve outcome as compared to a last-resort treatment. Low-dose infusion of AVP (0.6–2.4 U/h) has been demonstrated to be a safe adjunct in the management of septic shock. The V2 agonistic effects of AVP may exert favorable effects on hepatosplanchnic, renal, pulmonary, and coronary perfusion. However, the higher V1 receptor selectivity of TP may prove more potent in restoring arterial blood pressure and avoiding rebound hypotension, while carrying the risk of sustained global and regional vasoconstriction after bolus injection.

Conclusions

Evidence from experimental studies and initial clinical reports suggests that continuous low-dose infusion of TP may stabilize hemodynamics in septic shock with reduced side effects. However, randomized, controlled trials are necessary to determine the role of bolus or continuous infusion of TP in the treatment of septic shock before this approach can be recommended for routine clinical use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Martin GS, Mannino DM, Eaton S, Moss M (2003) The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 348:1546–1554

    Article  PubMed  Google Scholar 

  2. Landry DW, Oliver JA (2001) The pathogenesis of vasodilatory shock. N Engl J Med 345:588–595

    Article  PubMed  CAS  Google Scholar 

  3. Ince C, Sinaasappel M (1999) Microcirculatory oxygenation and shunting in sepsis and shock. Crit Care Med 27:1369–1377

    Article  PubMed  CAS  Google Scholar 

  4. Landry DW, Levin HR, Gallant EM, Ashton RC Jr, Seo S, D'Alessandro D, Oz MC, Oliver JA (1997) Vasopressin deficiency contributes to the vasodilation of septic shock. Circulation 95:1122–1125

    PubMed  CAS  Google Scholar 

  5. Sharshar T, Carlier R, Blanchard A, Feydy A, Gray F, Paillard M, Raphael JC, Gajdos P, Annane D (2002) Depletion of neurohypophyseal content of vasopressin in septic shock. Crit Care Med 30:497–500

    Article  PubMed  CAS  Google Scholar 

  6. Papanek PE, Sladek CD, Raff H (1997) Corticosterone inhibition of osmotically stimulated vasopressin from hypothalamic-neurohypophysial explants. Am J Physiol 272:R158–162

    PubMed  CAS  Google Scholar 

  7. Day TA, Randle JC, Renaud LP (1985) Opposing alpha- and beta-adrenergic mechanisms mediate dose-dependent actions of noradrenaline on supraoptic vasopressin neurones in vivo. Brain Res 358:171–179

    Article  PubMed  CAS  Google Scholar 

  8. Zerbe RL, Henry DP, Robertson GL (1983) Vasopressin response to orthostatic hypotension. Etiologic and clinical implications. Am J Med 74:265–271

    Article  PubMed  CAS  Google Scholar 

  9. Giusti-Paiva A, De Castro M, Antunes-Rodrigues J, Carnio EC (2002) Inducible nitric oxide synthase pathway in the central nervous system and vasopressin release during experimental septic shock. Crit Care Med 30:1306–1310

    Article  PubMed  CAS  Google Scholar 

  10. Westphal M, Stubbe H, Sielenkamper AW, Ball C, Van Aken H, Borgulya R, Bone HG (2003) Effects of titrated arginine vasopressin on hemodynamic variables and oxygen transport in healthy and endotoxemic sheep. Crit Care Med 31:1502–1508

    Article  PubMed  CAS  Google Scholar 

  11. Westphal M, Stubbe H, Sielenkamper AW, Borgulya R, Van Aken H, Ball C, Bone HG (2003) Terlipressin dose response in healthy and endotoxemic sheep: impact on cardiopulmonary performance and global oxygen transport. Intensive Care Med 29:301–308

    PubMed  Google Scholar 

  12. Leone M, Albanese J, Delmas A, Chaabane W, Garnier F, Martin C (2004) Terlipressin in catecholamine-resistant septic shock patients. Shock 22:314–319

    Article  PubMed  CAS  Google Scholar 

  13. Scharte M, Meyer J, Van Aken H, Bone HG (2001) Hemodynamic effects of terlipressin (a synthetic analog of vasopressin) in healthy and endotoxemic sheep. Crit Care Med 29:1756–1760

    Article  PubMed  CAS  Google Scholar 

  14. Klinzing S, Simon M, Reinhart K, Bredle DL, Meier-Hellmann A (2003) High-dose vasopressin is not superior to norepinephrine in septic shock. Crit Care Med 31:2646–2650

    Article  PubMed  CAS  Google Scholar 

  15. Morelli A, Rocco M, Conti G, Orecchioni A, De Gaetano A, Cortese G, Coluzzi F, Vernaglione E, Pelaia P, Pietropaoli P (2004) Effects of terlipressin on systemic and regional haemodynamics in catecholamine-treated hyperkinetic septic shock. Intensive Care Med 30:597–604

    Article  PubMed  Google Scholar 

  16. Medel J, Boccara G, Van de Steen E, Bertrand M, Godet G, Coriat P (2001) Terlipressin for treating intraoperative hypotension: can it unmask myocardial ischemia? Anesth Analg 93:53–55

    Article  PubMed  CAS  Google Scholar 

  17. Dunser MW, Mayr AJ, Tur A, Pajk W, Barbara F, Knotzer H, Ulmer H, Hasibeder WR (2003) Ischemic skin lesions as a complication of continuous vasopressin infusion in catecholamine-resistant vasodilatory shock: incidence and risk factors. Crit Care Med 31:1394–1398

    Article  PubMed  CAS  Google Scholar 

  18. Fellahi JL, Benard P, Daccache G, Mourgeon E, Gerard JL (2003) Vasodilatory septic shock refractory to catecholamines: is there a role for terlipressin? Ann Fr Anesth Reanim 22:631–634

    Article  PubMed  CAS  Google Scholar 

  19. Albanese J, Leone M, Delmas A, Martin C (2005) Terlipressin or norepinephrine in hyperdynamic septic shock: a prospective, randomized study. Crit Care Med 33:1897–1902

    Article  PubMed  CAS  Google Scholar 

  20. Dunser MW, Mayr AJ, Ulmer H, Ritsch N, Knotzer H, Pajk W, Luckner G, Mutz NJ, Hasibeder WR (2001) The effects of vasopressin on systemic hemodynamics in catecholamine-resistant septic and postcardiotomy shock: a retrospective analysis. Anesth Analg 93:7–13

    Article  PubMed  CAS  Google Scholar 

  21. Schrier RW, Berl T, Anderson RJ (1979) Osmotic and nonosmotic control of vasopressin release. Am J Physiol 236:F321–332

    PubMed  CAS  Google Scholar 

  22. Fabian M, Forsling ML, Jones JJ, Pryor JS (1969) The clearance and antidiuretic potency of neurohypophysial hormones in man, and their plasma binding and stability. J Physiol (Lond) 204:653–668

    CAS  Google Scholar 

  23. Holmes CL, Landry DW, Granton JT (2003) Science review: vasopressin and the cardiovascular system part 1-receptor physiology. Crit Care 7:427–434

    Article  PubMed  Google Scholar 

  24. Umino T, Kusano E, Muto S, Akimoto T, Yanagiba S, Ono S, Amemiya M, Ando Y, Homma S, Ikeda U, Shimada K, Asano Y (1999) AVP inhibits LPS- and IL-1beta-stimulated NO and cGMP via V1 receptor in cultured rat mesangial cells. Am J Physiol 276:F433–441

    PubMed  CAS  Google Scholar 

  25. Wakatsuki T, Nakaya Y, Inoue I (1992) Vasopressin modulates K (+)-channel activities of cultured smooth muscle cells from porcine coronary artery. Am J Physiol 263:H491–496

    PubMed  CAS  Google Scholar 

  26. Wenzel V, Lindner KH (2001) Employing vasopressin during cardiopulmonary resuscitation and vasodilatory shock as a lifesaving vasopressor. Cardiovasc Res 51:529–541

    Article  PubMed  CAS  Google Scholar 

  27. Tan SG, Koay CK, Chan ST (2002) The use of vasopressin to treat catecholamine-resistant hypotension after phaeochromocytoma removal. Anaesth Intensive Care 30:477–480

    PubMed  CAS  Google Scholar 

  28. Bankir L, Fernandes S, Bardoux P, Bouby N, Bichet DG (2005) Vasopressin-V2 receptor stimulation reduces sodium excretion in healthy humans. J Am Soc Nephrol 16:1920–1928

    Article  PubMed  CAS  Google Scholar 

  29. Knepper MA, Inoue T (1997) Regulation of aquaporin-2 water channel trafficking by vasopressin. Curr Opin Cell Biol 9:560–564

    Article  PubMed  CAS  Google Scholar 

  30. Tsuneyoshi I, Yamada H, Kakihana Y, Nakamura M, Nakano Y, Boyle WA, 3rd (2001) Hemodynamic and metabolic effects of low-dose vasopressin infusions in vasodilatory septic shock. Crit Care Med 29:487–493

    Article  PubMed  CAS  Google Scholar 

  31. Edwards RM, Trizna W, Kinter LB (1989) Renal microvascular effects of vasopressin and vasopressin antagonists. Am J Physiol 256:F274–278

    PubMed  CAS  Google Scholar 

  32. Tamaki T, Kiyomoto K, He H, Tomohiro A, Nishiyama A, Aki Y, Kimura S, Abe Y (1996) Vasodilation induced by vasopressin V2 receptor stimulation in afferent arterioles. Kidney Int 49:722–729

    Article  PubMed  CAS  Google Scholar 

  33. Eichinger MR, Walker BR (1994) Enhanced pulmonary arterial dilation to arginine vasopressin in chronically hypoxic rats. Am J Physiol 267:H2413–2419

    PubMed  CAS  Google Scholar 

  34. Evora PR, Pearson PJ, Schaff HV (1993) Arginine vasopressin induces endothelium-dependent vasodilatation of the pulmonary artery. V1-receptor-mediated production of nitric oxide. Chest 103:1241–1245

    Article  PubMed  CAS  Google Scholar 

  35. Russ RD, Walker BR (1992) Role of nitric oxide in vasopressinergic pulmonary vasodilatation. Am J Physiol 262:H743–747

    PubMed  CAS  Google Scholar 

  36. Sai Y, Okamura T, Amakata Y, Toda N (1995) Comparison of responses of canine pulmonary artery and vein to angiotensin II, bradykinin and vasopressin. Eur J Pharmacol 282:235–241

    Article  PubMed  CAS  Google Scholar 

  37. Evora PR, Pearson PJ, Rodrigues AJ, Viaro F, Schaff HV (2003) Effect of arginine vasopressin on the canine epicardial coronary artery: experiments on V1-receptor-mediated production of nitric oxide. Arq Bras Cardiol 80:483–494

    PubMed  Google Scholar 

  38. Okamura T, Ayajiki K, Fujioka H, Toda N (1999) Mechanisms underlying arginine vasopressin-induced relaxation in monkey isolated coronary arteries. J Hypertens 17:673–678

    Article  PubMed  CAS  Google Scholar 

  39. Bichet DG, Razi M, Lonergan M, Arthus MF, Papukna V, Kortas C, Barjon JN (1988) Hemodynamic and coagulation responses to 1-desamino [8-D-arginine] vasopressin in patients with congenital nephrogenic diabetes insipidus. N Engl J Med 318:881–887

    Article  PubMed  CAS  Google Scholar 

  40. Phillips PA, Abrahams JM, Kelly JM, Mooser V, Trinder D, Johnston CI (1990) Localization of vasopressin binding sites in rat tissues using specific V1 and V2 selective ligands. Endocrinology 126:1478–1484

    PubMed  CAS  Google Scholar 

  41. Braunwald E, Wagner HN Jr (1956) The pressor effect of the antidiuretic principle of the posterior pituitary in orthostatic hypotension. J Clin Invest 35:1412–1418

    Article  PubMed  CAS  Google Scholar 

  42. Grollman A, Geiling EMK (1932) The cardiovascular and metabolic reactions of man to the intramuscular injection of posterior pituitary liquid (pituirin), pitressin and pitocin. J Pharmacol Exp Ther 46:447–460

    CAS  Google Scholar 

  43. Schwartz J, Keil LC, Maselli J, Reid IA (1983) Role of vasopressin in blood pressure regulation during adrenal insufficiency. Endocrinology 112:234–238

    PubMed  CAS  Google Scholar 

  44. Schwartz J, Reid IA (1981) Effect of vasopressin blockade on blood pressure regulation during hemorrhage in conscious dogs. Endocrinology 109:1778–1780

    Article  PubMed  CAS  Google Scholar 

  45. Baker CH, Wilmoth FR (1984) Microvascular responses to E. coli endotoxin with altered adrenergic activity. Circ Shock 12:165–176

    PubMed  CAS  Google Scholar 

  46. Bersten AD, Hersch M, Cheung H, Rutledge FS, Sibbald WJ (1992) The effect of various sympathomimetics on the regional circulations in hyperdynamic sepsis. Surgery 112:549–561

    PubMed  CAS  Google Scholar 

  47. Chernow B, Roth BL (1986) Pharmacologic manipulation of the peripheral vasculature in shock: clinical and experimental approaches. Circ Shock 18:141–155

    PubMed  CAS  Google Scholar 

  48. Pleiner J, Heere-Ress E, Langenberger H, Sieder AE, Bayerle-Eder M, Mittermayer F, Fuchsjager-Mayrl G, Bohm J, Jansen B, Wolzt M (2002) Adrenoceptor hyporeactivity is responsible for Escherichia coli endotoxin-induced acute vascular dysfunction in humans. Arterioscler Thromb Vasc Biol 22:95–100

    Article  PubMed  CAS  Google Scholar 

  49. Baker CH, Sutton ET, Zhou Z, Dietz JR (1990) Microvascular vasopressin effects during endotoxin shock in the rat. Circ Shock 30:81–95

    PubMed  CAS  Google Scholar 

  50. Landry DW, Levin HR, Gallant EM, Seo S, D'Alessandro D, Oz MC, Oliver JA (1997) Vasopressin pressor hypersensitivity in vasodilatory septic shock. Crit Care Med 25:1279–1282

    Article  PubMed  CAS  Google Scholar 

  51. Williams TD, Da Costa D, Mathias CJ, Bannister R, Lightman SL (1986) Pressor effect of arginine vasopressin in progressive autonomic failure. Clin Sci (Lond) 71:173–178

    CAS  Google Scholar 

  52. Barrett LK, Singer M, Clapp LH (2007) Vasopressin: mechanisms of action on the vasculature in health and in septic shock. Crit Care Med 35:33–40

    Article  PubMed  CAS  Google Scholar 

  53. Ertmer C, Bone HG, Morelli A, Van Aken H, Erren M, Lange M, Traber DL, Westphal M (2007) Methylprednisolone reverses vasopressin hyporesponsiveness in ovine endotoxemia. Shock 27:281–288

    Article  PubMed  CAS  Google Scholar 

  54. Bucher M, Hobbhahn J, Taeger K, Kurtz A (2002) Cytokine-mediated downregulation of vasopressin V (1A) receptors during acute endotoxemia in rats. Am J Physiol Regul Integr Comp Physiol 282:R979–984

    PubMed  CAS  Google Scholar 

  55. Patel BM, Chittock DR, Russell JA, Walley KR (2002) Beneficial effects of short-term vasopressin infusion during severe septic shock. Anesthesiology 96:576–582

    Article  PubMed  CAS  Google Scholar 

  56. Leather HA, Segers P, Berends N, Vandermeersch E, Wouters PF (2002) Effects of vasopressin on right ventricular function in an experimental model of acute pulmonary hypertension. Crit Care Med 30:2548–2552

    Article  PubMed  CAS  Google Scholar 

  57. Martikainen TJ, Tenhunen JJ, Uusaro A, Ruokonen E (2003) The effects of vasopressin on systemic and splanchnic hemodynamics and metabolism in endotoxin shock. Anesth Analg 97:1756–1763

    Article  PubMed  Google Scholar 

  58. Westphal M, Freise H, Kehrel BE, Bone HG, Van Aken H, Sielenkamper AW (2004) Arginine vasopressin compromises gut mucosal microcirculation in septic rats. Crit Care Med 32:194–200

    Article  PubMed  CAS  Google Scholar 

  59. Dunser MW, Mayr AJ, Ulmer H, Knotzer H, Sumann G, Pajk W, Friesenecker B, Hasibeder WR (2003) Arginine vasopressin in advanced vasodilatory shock: a prospective, randomized, controlled study. Circulation 107:2313–2319

    Article  PubMed  CAS  Google Scholar 

  60. Holmes CL, Walley KR, Chittock DR, Lehman T, Russell JA (2001) The effects of vasopressin on hemodynamics and renal function in severe septic shock: a case series. Intensive Care Med 27:1416–1421

    Article  PubMed  CAS  Google Scholar 

  61. Luckner G, Dunser MW, Jochberger S, Mayr VD, Wenzel V, Ulmer H, Schmid S, Knotzer H, Pajk W, Hasibeder W, Mayr AJ, Friesenecker B (2005) Arginine vasopressin in 316 patients with advanced vasodilatory shock. Crit Care Med 33:2659–2666

    Article  PubMed  CAS  Google Scholar 

  62. Laszlo FA, Laszlo F Jr, De Wied D (1991) Pharmacology and clinical perspectives of vasopressin antagonists. Pharmacol Rev 43:73–108

    PubMed  CAS  Google Scholar 

  63. Pollock WK, MacIntyre DE (1986) Desensitization and antagonism of vasopressin-induced phosphoinositide metabolism and elevation of cytosolic free calcium concentration in human platelets. Biochem J 234:67–73

    PubMed  CAS  Google Scholar 

  64. Lachant NA, Smith MR, Xie ZJ, Romani WR (1995) Heterogeneity of the aggregation response of human platelets to arginine vasopressin. Am J Hematol 49:56–66

    Article  PubMed  CAS  Google Scholar 

  65. Malay MB, Ashton RC Jr, Landry DW, Townsend RN (1999) Low-dose vasopressin in the treatment of vasodilatory septic shock. J Trauma 47:699–703

    PubMed  CAS  Google Scholar 

  66. Sun Q, Dimopoulos G, Nguyen DN, Tu Z, Nagy N, Hoang AD, Rogiers P, De Backer D, Vincent JL (2003) Low-dose vasopressin in the treatment of septic shock in sheep. Am J Respir Crit Care Med 168:481–486

    Article  PubMed  Google Scholar 

  67. van Haren FM, Rozendaal FW, van der Hoeven JG (2003) The effect of vasopressin on gastric perfusion in catecholamine-dependent patients in septic shock. Chest 124:2256–2260

    Article  PubMed  Google Scholar 

  68. Russell JA Hemodynamic support of sepsis (2007) Vasopressin versus norepinephrine for septic shock. Program and abstracts of Society of Critical Care Medicine Congress February 17–21, 2007, Orlando, Florida

    Google Scholar 

  69. Dunser MW, Hasibeder WR, Wenzel V, Schwarz S, Ulmer H, Knotzer H, Pajk W, Friesenecker BE, Mayr AJ (2004) Endocrinologic response to vasopressin infusion in advanced vasodilatory shock. Crit Care Med 32:1266–1271

    Article  PubMed  CAS  Google Scholar 

  70. Pesaturo AB, Jennings HR, Voils SA (2006) Terlipressin: vasopressin analog and novel drug for septic shock. Ann Pharmacother 40:2170–2177

    Article  PubMed  CAS  Google Scholar 

  71. Bernadich C, Bandi JC, Melin P, Bosch J (1998) Effects of F-180, a new selective vasoconstrictor peptide, compared with terlipressin and vasopressin on systemic and splanchnic hemodynamics in a rat model of portal hypertension. Hepatology 27:351–356

    Article  PubMed  CAS  Google Scholar 

  72. Nilsson G, Lindblom P, Ohlin M, Berling R, Vernersson E (1990) Pharmacokinetics of terlipressin after single i.v. doses to healthy volunteers. Drugs Exp Clin Res 16:307–314

    PubMed  CAS  Google Scholar 

  73. Forsling ML, Aziz LA, Miller M, Davies R, Donovan B (1980) Conversion of triglycylvasopressin to lysine-vasopressin in man. J Endocrinol 85:237–244

    Article  PubMed  CAS  Google Scholar 

  74. O'Brien A, Clapp L, Singer M (2002) Terlipressin for norepinephrine-resistant septic shock. Lancet 359:1209–1210

    Article  PubMed  Google Scholar 

  75. Asfar P, Hauser B, Ivanyi Z, Ehrmann U, Kick J, Albicini M, Vogt J, Wachter U, Bruckner UB, Radermacher P, Bracht H (2005) Low-dose terlipressin during long-term hyperdynamic porcine endotoxemia: effects on hepatosplanchnic perfusion, oxygen exchange, and metabolism. Crit Care Med 33:373–380

    Article  PubMed  CAS  Google Scholar 

  76. Asfar P, Pierrot M, Veal N, Moal F, Oberti F, Croquet V, Douay O, Gallois Y, Saumet JL, Alquier P, Cales P (2003) Low-dose terlipressin improves systemic and splanchnic hemodynamics in fluid-challenged endotoxic rats. Crit Care Med 31:215–220

    Article  PubMed  CAS  Google Scholar 

  77. Ioannou G, Doust J, Rockey DC (2001) Terlipressin for acute esophageal variceal hemorrhage. Cochrane Database Syst Rev:CD002147

  78. Moller S, Hansen EF, Becker U, Brinch K, Henriksen JH, Bendtsen F (2000) Central and systemic haemodynamic effects of terlipressin in portal hypertensive patients. Liver 20:51–59

    Article  PubMed  CAS  Google Scholar 

  79. Ertmer C, Bone HG, Van Aken H, Westphal M (2006) Terlipressin for haemodynamic support in septic shock: less may be more. Resuscitation 70:292–293

    Article  PubMed  Google Scholar 

  80. Westphal M, Traber DL (2005) Low-dose terlipressin for hemodynamic support in sepsis and systemic inflammatory response syndrome: art for (he) art's sake or state of the art? Crit Care Med 33:455–457

    Article  PubMed  Google Scholar 

  81. Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, Gea-Banacloche J, Keh D, Marshall JC, Parker MM, Ramsay G, Zimmerman JL, Vincent JL, Levy MM (2004) Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med 32:858–873

    Article  PubMed  Google Scholar 

  82. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345:1368–1377

    Article  PubMed  CAS  Google Scholar 

  83. Asfar P (2003) Terlipressin in chronic hyperdynamic endotoxic shock: is it safe? Intensive Care Med 29:154–155

    PubMed  Google Scholar 

  84. Cooper KE, Kasting NW, Lederis K, Veale WL (1979) Evidence supporting a role for endogenous vasopressin in natural suppression of fever in the sheep. J Physiol (Lond) 295:33–45

    CAS  Google Scholar 

  85. Cooper KE, Naylor AM, Veale WL (1987) Evidence supporting a role for endogenous vasopressin in fever suppression in the rat. J Physiol (Lond) 387:163–172

    CAS  Google Scholar 

  86. Lange M, Morelli A, Ertmer C, Koehler G, Broking K, Hucklenbruch C, Bone HG, Van Aken H, Traber DL, Westphal M (2007) Continuous versus bolus infusion of terlipressin in ovine endotoxemia. Shock 28:623–629

    Article  PubMed  CAS  Google Scholar 

  87. Zeballos G, Lopez-Herce J, Fernandez C, Brandstrup KB, Rodriguez-Nunez A (2006) Rescue therapy with terlipressin by continuous infusion in a child with catecholamine-resistant septic shock. Resuscitation 68:151–153

    Article  PubMed  Google Scholar 

  88. Morelli A, Ertmer C, Lange M, Westphal M (2007) Continuous terlipressin infusion in patients with septic shock: less may be best, and the earlier the better? Intensive Care Med 33:1669–1670

    Article  PubMed  Google Scholar 

  89. Jolley DH, De Keulenaer BL, Potter A, Stephens DP (2003) Terlipressin infusion in catecholamine-resistant shock. Anaesth Intensive Care 31:560–564

    PubMed  CAS  Google Scholar 

  90. Malay MB, Ashton JL, Dahl K, Savage EB, Burchell SA, Ashton RC Jr, Sciacca RR, Oliver JA, Landry DW (2004) Heterogeneity of the vasoconstrictor effect of vasopressin in septic shock. Crit Care Med 32:1327–1331

    Article  PubMed  CAS  Google Scholar 

  91. Petersen MB (2006) The effect of vasopressin and related compounds at V1a and V2 receptors in animal models relevant to human disease. Basic Clin Pharmacol Toxicol 99:96–103

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care, University of Münster, Albert-Schweitzer-Strasse 33, 48149, Münster, Germany

    Matthias Lange, Christian Ertmer & Martin Westphal

Authors
  1. Matthias Lange
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christian Ertmer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Martin Westphal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Matthias Lange.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lange, M., Ertmer, C. & Westphal, M. Vasopressin vs. terlipressinin the treatmentof cardiovascular failure in sepsis. Intensive Care Med 34, 821–832 (2008). https://doi.org/10.1007/s00134-007-0946-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00134-007-0946-y

Keywords

Search

Navigation