Advertisement

Critical Care

, 11:P35 | Cite as

Rebound hypotension following terlipressin bolus infusion can be prevented by continuous low-dose infusion of terlipressin

  • M Lange
  • K Bröking
  • C Ertmer
  • D Traber
  • C Hucklenbruch
  • H Van Aken
  • M Westphal
Poster presentation

Keywords

Mean Arterial Pressure Bolus Injection Pulmonary Vascular Resistance Terlipressin Bolus Infusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Introduction

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.

Methods

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.

Results

Continuous infusion of terlipressin reversed the endotoxin-induced decrease in MAP during the entire 24-hour study period (P < 0.001). Intermittent bolus injections of terlipressin contributed to overshooting increases in MAP, as well as in systemic and pulmonary vascular resistance index (each P < 0.001), which were followed by sudden and strong rebound effects (Figure 1).
Figure 1

Mean arterial pressure (MAP) during continuous and intermittent bolus infusion of terlipressin in endotexemic ewes.

Conclusion

A goal-directed continuous infusion of terlipressin may be superior to terlipressin bolus injection to treat patients with sepsis-related arterial hypotension.

Copyright information

© BioMed Central Ltd. 2007

Authors and Affiliations

  • M Lange
    • 1
  • K Bröking
    • 1
  • C Ertmer
    • 1
  • D Traber
    • 2
  • C Hucklenbruch
    • 1
  • H Van Aken
    • 1
  • M Westphal
    • 1
  1. 1.University of MünsterGermany
  2. 2.The University of Texas Medical BranchGalvestonUSA

Personalised recommendations