Terlipressin as rescue therapy for intractable hypotension during neonatal septic shock.
OBJECTIVE
To report the successful use of terlipressin in an 8-day-old infant for treatment of intractable hypotension caused by septic shock.


METHODS
Descriptive case report.


METHODS
An 18-bed pediatric intensive care unit at a tertiary care children's hospital.


METHODS
An 8-day-old child with intractable hypotension due to septic shock after heart surgery.


METHODS
General supportive intensive care including mechanical ventilatory support, volume replacement, and inotropic support with dopamine 20 microg.kg(-1).min(-1), milrinone 0.75 microg.kg(-1).min(-1), and epinephrine 0.8 microg.kg(-1).min(-1).


RESULTS
Terlipressin (7 microg/kg per dose twice daily) was added as rescue therapy because of profound intractable hypotension. Shortly after the beginning of treatment, blood pressure and perfusion dramatically improved.


CONCLUSIONS
There is circumstantial evidence that the administration of terlipressin caused the increase in blood pressure. We suggest that terlipressin should be considered as rescue therapy when high-dose catecholamine therapy does not result in sufficient perfusion pressure. Further investigation is needed to prove terlipressin's effectiveness and safety in infants and children.
Department of Pharmacy Services, Safra Children's Hospital, The Chaim Sheba Medical Center, Tel Hashomer and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Ilan
I
Matok
Leah
L
Leibovitch
Amir
A
Vardi
Miriam
M
Adam
Marina
M
Rubinshtein
Zohar
Z
Barzilay
Gideon
G
Paret
D001794:Blood Pressure / Q000187:drug effects; D002395:Catecholamines / Q000627:therapeutic use; D006801:Humans; D007022:Hypotension / Q000188:drug therapy* / Q000209:etiology; D007231:Infant, Newborn; D007275:Injections, Intravenous; D007710:Klebsiella Infections / Q000150:complications; D008236:Lypressin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D008297:Male; D012772:Shock, Septic / Q000188:drug therapy* / Q000209:etiology; D000077585:Terlipressin; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D002395:Catecholamines; D014662:Vasoconstrictor Agents; D008236:Lypressin; D000077585:Terlipressin