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Related Experiment Videos

Terlipressin or norepinephrine in hyperdynamic septic shock: a prospective, randomized study.

Jacques Albanèse1, Marc Leone, Anne Delmas

  • 1Department of Intensive Care Medicine and Trauma Center, Hospital Nord, Marseille Cedex 20, France.

Critical Care Medicine
|September 9, 2005
PubMed
Summary

In hyperdynamic septic shock, both norepinephrine and terlipressin raise blood pressure. Terlipressin, however, decreases cardiac index and oxygen consumption, unlike norepinephrine. Both drugs improve renal function.

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Area of Science:

  • Critical Care Medicine
  • Pharmacology
  • Nephrology

Background:

  • Hyperdynamic septic shock is a life-threatening condition characterized by vasodilation and increased cardiac output.
  • Maintaining adequate blood pressure and organ perfusion is crucial in managing septic shock.
  • Norepinephrine and terlipressin are vasopressors used in septic shock, but their comparative effects on hemodynamics and renal function require further elucidation.

Purpose of the Study:

  • To compare the effects of norepinephrine versus terlipressin on hemodynamic variables and renal function in adult patients with hyperdynamic septic shock.
  • To assess the impact of these vasopressors on oxygen delivery and consumption.
  • To evaluate changes in urine flow and creatinine clearance.

Main Methods:

Related Experiment Videos

  • A prospective, randomized, open-label study was conducted in an intensive care unit.
  • Twenty adult patients with hyperdynamic septic shock, following fluid resuscitation, were enrolled.
  • Patients were randomized to receive either norepinephrine or terlipressin, with comprehensive hemodynamic monitoring and renal function assessments.

    • Main Results:

    • Both norepinephrine and terlipressin significantly increased mean arterial pressure, systemic vascular resistance, and pulmonary vascular resistance.
    • Terlipressin, but not norepinephrine, led to a significant decrease in heart rate and cardiac index, without altering stroke volume.
    • Oxygen delivery and consumption indices decreased significantly with terlipressin, while renal function, indicated by urine flow and creatinine clearance, improved with both agents.

    Conclusions:

    • Norepinephrine and terlipressin effectively increase mean arterial blood pressure in hyperdynamic septic shock.
    • Terlipressin's blood pressure-raising effect comes at the cost of reduced cardiac index and oxygen consumption, unlike norepinephrine.
    • Both vasopressors enhance renal function; further research into synergistic strategies, like terlipressin with dobutamine, is warranted to maintain cardiac output.