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Terlipressin for catecholamine-resistant septic shock in children

Abstract

Objective

To report the effects of terlipressin treatment in four paediatric patients with catecholamine-resistant hypotensive septic shock.

Design and setting

Case report in the pediatric intensive care unit of a university hospital.

Patients

Four children with severe septic shock and hypotension resistant to high doses of norepinephrine and other cathecolamines.

Interventions

Terlipressin was added to the standard treatment, by intravenous bolus at a dose of 0.02 mg/kg every 4 h during a maximum time of 3 days.

Measurement and results

In all cases, terlipressin induced a rapid and sustained improvement in mean arterial pressure, which allowed the lessening or even withdrawal of norepinephrine infusion. No related adverse effects were detected.

Conclusion

Terlipressin might be considered, at least as a rescue therapy, for hypotension resistant to catecholamines in children with septic shock. Further studies are needed to confirm the beneficial effects found in our patients. The optimal administration schedule remains to be elucidated.

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Correspondence to Antonio Rodríguez-Núñez.

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Rodríguez-Núñez, A., Fernández-Sanmartín, M., Martinón-Torres, F. et al. Terlipressin for catecholamine-resistant septic shock in children. Intensive Care Med 30, 477–480 (2004). https://doi.org/10.1007/s00134-003-2114-3

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Keywords

  • Terlipressin
  • Children
  • Septic shock
  • Multiple organ failure
  • Hypotension
  • Norepinephrine