title: Pediatric cardiac arrest refractory to advanced life support: is there a role for terlipressin?
abstract: OBJECTIVE
  Pediatric cardiac arrest unresponsive to advanced life support and several adrenaline doses has a very poor prognosis. Alternative vasopressors could improve the results of resuscitation in such cases. We report our experience with the compassionate administration of terlipressin in children who suffered in-pediatric intensive care unit cardiac arrest and did not respond to immediate advanced life support and at least three epinephrine doses.
  
  
  METHODS
  Prospective multicenter registry.
  
  
  METHODS
  Three pediatric intensive care units at university-affiliated tertiary care children's hospitals.
  
  
  METHODS
  Five pediatric patients, aged 5 mos to 12 yrs, with in-pediatric intensive care unit cardiac arrest unresponsive to advanced life support that included at least three epinephrine doses.
  
  
  METHODS
  Addition of terlipressin (10-20 microg/kg intravenous, up to two doses) to standard cardiopulmonary resuscitation.
  
  
  RESULTS
  Sustained return of spontaneous circulation was achieved in four cases, two of them were declared dead 6 and 12 hrs later, and the remaining two survived without cardiopulmonary procedures-related sequelae and with good neurologic condition.
  
  
  CONCLUSIONS
  Terlipressin might contribute to obtain sustained return of spontaneous circulation in children with refractory in-hospital cardiac arrest. A randomized controlled clinical trial should be conducted to investigate the optimal drug treatment in pediatric cardiac arrest.
authors: Pediatric Intensive Care Unit, Hospital de Cruces, Barakaldo, Bizkaia, Spain.
authors: Javier
authors: J
authors: Gil-Antón
authors: Jesús
authors: J
authors: López-Herce
authors: Elvira
authors: E
authors: Morteruel
authors: Angel
authors: A
authors: Carrillo
authors: Antonio
authors: A
authors: Rodríguez-Núñez
mesh_terms: D022561:Advanced Cardiac Life Support; D002648:Child; D002675:Child, Preschool; D057176:Compassionate Use Trials; D004305:Dose-Response Relationship, Drug; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008236:Lypressin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D011446:Prospective Studies; D000077585:Terlipressin; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D014662:Vasoconstrictor Agents; D008236:Lypressin; D000077585:Terlipressin