title: A retrospective analysis of Terlipressin infusion in patients with refractory hypotension after cardiac surgery.
abstract: OBJECTIVE
  The aim of this retrospective study was to evaluate the effectiveness of Terlipressin in the treatment of severe hypotension in cardiosurgical patients and to assess the differences between the groups of survivors and nonsurvivors.
  
  
  METHODS
  The study population was 27 patients who developed hypotension after cardiac surgery.
  
  
  RESULTS
  All surviving patients developed refractory hypotension early after extracorporeal circulation. Of the 9 nonsurvivors, 3 also experienced postcardiotomy hypotension, while the remaining 6 developed severe hypotension during sepsis. Terlipressin given continuously significantly increased the mean arterial pressure and reduced the heart rate in both groups. Norepinephrine requirements decreased significantly among survivors only. The mean pulmonary artery pressure and pulmonary capillary wedge pressure levels remained unchanged or increased insignificantly, while several liver markers in the survivor group significantly increased.
  
  
  CONCLUSIONS
  Terlipressin given continuously is a potent vasopressor in patients with norepinephrine-resistant postcardiotomy hypotension; however, Terlipressin treatment failed in patients who developed refractory hypotension during sepsis. We cannot recommend this therapy in such patients as it proved to be hemodynamicaly ineffective and may even worsen the circulatory situation.
authors.affiliation: Department of Anesthesia, Resuscitation and Intensive Medicine, General University Hospital, Prague, Czech Republic. jan.kunstyr@post.cz
authors.forename: J
authors.initials: J
authors.lastname: Kunstyr
authors.forename: D
authors.initials: D
authors.lastname: Lincova
authors.forename: M
authors.initials: M
authors.lastname: Mourad
authors.forename: M
authors.initials: M
authors.lastname: Lips
authors.forename: T
authors.initials: T
authors.lastname: Cermak
authors.forename: T
authors.initials: T
authors.lastname: Kotulak
authors.forename: J
authors.initials: J
authors.lastname: Blaha
authors.forename: D
authors.initials: D
authors.lastname: Rubes
authors.forename: M
authors.initials: M
authors.lastname: Matias
authors.forename: M
authors.initials: M
authors.lastname: Stritesky
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007022:Hypotension / Q000188:drug therapy* / Q000209:etiology; D007262:Infusions, Intravenous; D008236:Lypressin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D017741:Survivors; D000077585:Terlipressin; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D014662:Vasoconstrictor Agents; D008236:Lypressin; D000077585:Terlipressin