Terlipressin for catecholamine-resistant septic shock in children.
OBJECTIVE
To report the effects of terlipressin treatment in four paediatric patients with catecholamine-resistant hypotensive septic shock.


METHODS
Case report in the pediatric intensive care unit of a university hospital.


METHODS
Four children with severe septic shock and hypotension resistant to high doses of norepinephrine and other cathecolamines.


METHODS
Terlipressin was added to the standard treatment, by intravenous bolus at a dose of 0.02 mg/kg every 4 h during a maximum time of 3 days.


RESULTS
In all cases, terlipressin induced a rapid and sustained improvement in mean arterial pressure, which allowed the lessening or even withdrawal of norepinephrine infusion. No related adverse effects were detected.


CONCLUSIONS
Terlipressin might be considered, at least as a rescue therapy, for hypotension resistant to catecholamines in children with septic shock. Further studies are needed to confirm the beneficial effects found in our patients. The optimal administration schedule remains to be elucidated.
Rodríguez-Núñez
Antonio
A
Pediatric Emergency and Critical Care Division, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain, Antonio.Rodriguez.Nunez@sergas.es
Fernández-Sanmartín
Manuel
M
Martinón-Torres
Federico
F
González-Alonso
Natalia
N
Martinón-Sánchez
José María
JM
D002395:Catecholamines / Q000008:administration & dosage / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D004351:Drug Resistance; D006801:Humans; D007022:Hypotension / Q000188:drug therapy* / Q000209:etiology; D007223:Infant; D007262:Infusions, Intravenous; D008236:Lypressin / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D008297:Male; D012772:Shock, Septic / Q000150:complications / Q000188:drug therapy*; D000077585:Terlipressin; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
D002395:Catecholamines; D014662:Vasoconstrictor Agents; D008236:Lypressin; D000077585:Terlipressin