Terlipressin for septic shock patients: a meta-analysis of randomized controlled study View Full Text


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Article Info

DATE

2019-03-12

AUTHORS

Yibing Zhu, Huibin Huang, Xiuming Xi, Bin Du

ABSTRACT

Background: Catecholamines are commonly used in septic shock but face limitations of their hypo-responsiveness and adverse events due to high dose. Terlipressin is a synthetic vasopressin analog with greater selectivity for the V1-receptor. A meta-analysis was conducted to evaluate the efficacy and safety of terlipressin in septic shock. Methods: We searched for relevant studies in PubMed, Embase, and the Cochrane database from inception up to July 15, 2018. Randomized controlled trials (RCTs) were included if they reported data on any of the predefined outcomes in patients with septic shock and managed with terlipressin or any catecholamines. Results were expressed as risk ratio (RR) or mean difference (MD) with accompanying 95% confidence interval (CI). Heterogeneity, subgroup analysis, sensitivity analysis, and publication bias were explored. Results: Ten studies with 928 patients were included. Despite the shorter duration of mechanical ventilation, use of terlipressin did not reduce the risk of mortality (RR = 0.94; 95% CI, 0.85 to 1.05; I 2 = 0%; P = 0.28) when compared with control. This finding was confirmed by further subgroup and sensitivity analyses. In addition, lactate clearance, length of stay in ICU or hospital, total adverse events, digital ischemia, and arrhythmia were also similar between groups, while terlipressin was associated with shorter duration of mechanical ventilation and less norepinephrine requirements. Conclusions: Current results suggest terlipressin did not show added survival benefit in septic shock therapy when compared with catecholamines. More... »

PAGES

16

References to SciGraph publications

  • 2011-11-30. Vasopressin for treatment of vasodilatory shock: an ESICM systematic review and meta-analysis in INTENSIVE CARE MEDICINE
  • 2009-09-15. Comparing two different arginine vasopressin doses in advanced vasodilatory shock: a randomized, controlled, open-label trial in INTENSIVE CARE MEDICINE
  • 2012-08-14. Vasopressin and terlipressin in adult vasodilatory shock: a systematic review and meta-analysis of nine randomized controlled trials in CRITICAL CARE
  • 2017-01-18. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016 in INTENSIVE CARE MEDICINE
  • 2012-04-12. Adverse cardiac events during catecholamine vasopressor therapy: a prospective observational study in INTENSIVE CARE MEDICINE
  • 2013-01-09. Small studies may overestimate the effect sizes in critical care meta-analyses: a meta-epidemiological study in CRITICAL CARE
  • 2007-12-19. Terlipressin as a rescue therapy for catecholamine-resistant septic shock in children in INTENSIVE CARE MEDICINE
  • 2002-11-30. Terlipressin dose response in healthy and endotoxemic sheep: impact on cardiopulmonary performance and global oxygen transport in INTENSIVE CARE MEDICINE
  • 2009-08-10. Continuous terlipressin versus vasopressin infusion in septic shock (TERLIVAP): a randomized, controlled pilot study in CRITICAL CARE
  • 2014-12-19. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range in BMC MEDICAL RESEARCH METHODOLOGY
  • 2018-07-03. Terlipressin versus norepinephrine as infusion in patients with septic shock: a multicentre, randomised, double-blinded trial in INTENSIVE CARE MEDICINE
  • 2018-07-13. Terlipressin or norepinephrine, or both in septic shock? in INTENSIVE CARE MEDICINE
  • 2008-11-18. Efficacy and safety of terlipressin in cirrhotic patients with variceal bleeding or hepatorenal syndrome in ADVANCES IN THERAPY
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    https://www.ncbi.nlm.nih.gov/pubmed/30923620


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