Rebound hypotension following terlipressin bolus infusion can be prevented by continuous low-dose infusion of terlipressin
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KeywordsMean Arterial Pressure Bolus Injection Pulmonary Vascular Resistance Terlipressin Bolus Infusion
Bolus infusion of terlipressin, a vasopressin analog, increases the mean arterial pressure (MAP) in patients with sepsis-related arterial hypotension. However, bolus infusion of terlipressin may be associated with severe side effects like excessive systemic and pulmonary vasoconstriction. We hypothesized that continuous low-dose infusion of terlipressin may reverse arterial hypotension with reduced side effects.
Sixteen ewes were chronically instrumented to determine the hemodynamics of the systemic and pulmonary circulation. After 16 hours of endotoxin infusion, all sheep exhibited a hypotensive–hyperdynamic circulation. Thereafter, the animals were randomized to be treated with either a continuous (2 mg over 24 hours) or bolus infusion (1 mg every 6 hours) of terlipressin.
A goal-directed continuous infusion of terlipressin may be superior to terlipressin bolus injection to treat patients with sepsis-related arterial hypotension.