Document Detail


Terlipressin facilitates transport of septic patients treated with norepinephrine.
MedLine Citation:
PMID:  17125115     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Transport of hemodynamic unstable septic patients for diagnostic or therapeutic interventions outside the intensive care unit is complex but sometimes contributes to increasing the chance of survival. OBJECTIVES: To report our experience with terlipressin treatment for facilitation of transport to distant facilities for diagnostic or therapeutic procedures in septic patients treated with norepinephrine. METHODS: We conducted a retrospective analysis of the records of our ICU, identifying the patients with septic shock who required norepinephrine for hemodynamic support. RESULTS: Terlipressin was given to 30 septic shock patients (15 females and 15 males) who were on high dose norepinephrine (10 microg/min or more) in order to facilitate their transport outside the ICU. The dose of terlipressin ranged from 1 to 4 mg, with a mean of 2.13+/-0.68 mg. The dose of norepinephrine needed to maintain systolic blood pressure above 100 mmHg decreased following terlipressin administration, from 21.9+/-10.4 microg/min (range 5-52 microg/min) to 1.0+/-1.95 (range 0-10) (P < 0.001). No patients required norepinephrine dose adjustment during transport. No serious complications or overshoot in blood pressure values were observed following terlipressin administration. Acrocyanosis occurred only in eight patients receiving more than 1 mg of the drug. The overall mortality rate was 50%. CONCLUSIONS: Our data suggest that terlipressin is effective in septic shock. Because it is long-acting and necessitates less titration it might be indicated for patient transportation.
Authors:
Moti Klein; Natan Weksler; Avraham Borer; Leonid Koyfman; Jerome Kesslin; Gabriel M Gurman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Israel Medical Association journal : IMAJ     Volume:  8     ISSN:  1565-1088     ISO Abbreviation:  Isr. Med. Assoc. J.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-11-27     Completed Date:  2007-01-09     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  100930740     Medline TA:  Isr Med Assoc J     Country:  Israel    
Other Details:
Languages:  eng     Pagination:  691-3     Citation Subset:  IM    
Affiliation:
Department of Critical Care, Division of Anesthesiology and Critical Care, Soroka University Hospital, Beer Sheva, Israel. motiklein@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antihypertensive Agents / therapeutic use*
Blood Pressure / drug effects
Dose-Response Relationship, Drug
Female
Humans
Lypressin / analogs & derivatives*,  therapeutic use
Male
Middle Aged
Norepinephrine / administration & dosage*
Retrospective Studies
Shock, Septic / drug therapy*
Transportation of Patients / methods*
Vasoconstrictor Agents / administration & dosage*
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Vasoconstrictor Agents; 14636-12-5/terlipressin; 50-57-7/Lypressin; 51-41-2/Norepinephrine

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