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Comparison of Norepinephrine and Terlipressin vs Norepinephrine Alone for Management of Septic Shock: A Randomized Control Study

PURPOSE: To compare norepinephrine and terlipressin vs norepinephrine alone for management of septic shock. MATERIALS AND METHODS: In this prospective, randomized control trial, 50 adult patients with septic shock were randomized into two groups. Group I received a combination of injection terlipres...

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Autores principales: Sahoo, Pallavi, Kothari, Nikhil, Goyal, Shilpa, Sharma, Ankur, Bhatia, Pradeep K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jaypee Brothers Medical Publishers 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9237141/
https://www.ncbi.nlm.nih.gov/pubmed/35836627
http://dx.doi.org/10.5005/jp-journals-10071-24231
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author Sahoo, Pallavi
Kothari, Nikhil
Goyal, Shilpa
Sharma, Ankur
Bhatia, Pradeep K
author_facet Sahoo, Pallavi
Kothari, Nikhil
Goyal, Shilpa
Sharma, Ankur
Bhatia, Pradeep K
author_sort Sahoo, Pallavi
collection PubMed
description PURPOSE: To compare norepinephrine and terlipressin vs norepinephrine alone for management of septic shock. MATERIALS AND METHODS: In this prospective, randomized control trial, 50 adult patients with septic shock were randomized into two groups. Group I received a combination of injection terlipressin 0.02 µg/kg/min (fixed dose) infusion and injection norepinephrine 0.01 µg/kg/min infusion and group II received injection norepinephrine 0.01 µg/kg/min infusion alone. Dose of noradrenaline in both the groups was titrated to achieve the target MAP of 65–70 mm Hg. The data collected were the dose of norepinephrine required to maintain an MAP of above 65 mm Hg, urine output, serum lactate, procalcitonin level, C-reactive protein, sequential organ failure assessment (SOFA) score, total duration of vasopressor support, and incidences of the adverse effects. RESULTS: The norepinephrine dose in group I vs group II at 12 hours was found to be 0.141 ± 0.067 vs 0.374 ± 0.096 µg/kg/min (p ≤0.005). The serum lactate was lower, and urine output was higher in group I than group II (p <0.05). Group I had a significantly greater reduction in SOFA score in 12 hours than group II. Group I patient also had a significant decrease in the duration of vasopressor administration than group II patients being discharged from the ICU. However, there was no difference in the mortality between the two groups during their ICU stay. CONCLUSION: A low-dose continuous infusion of terlipressin and norepinephrine could help attain early resuscitation goals for managing patients with septic shock. HOW TO CITE THIS ARTICLE: Sahoo P, Kothari N, Goyal S, Sharma A, Bhatia PK. Comparison of Norepinephrine and Terlipressin vs Norepinephrine Alone for Management of Septic Shock: A Randomized Control Study. Indian J Crit Care Med 2022;26(6):669–675.
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spelling pubmed-92371412022-07-13 Comparison of Norepinephrine and Terlipressin vs Norepinephrine Alone for Management of Septic Shock: A Randomized Control Study Sahoo, Pallavi Kothari, Nikhil Goyal, Shilpa Sharma, Ankur Bhatia, Pradeep K Indian J Crit Care Med Original Article PURPOSE: To compare norepinephrine and terlipressin vs norepinephrine alone for management of septic shock. MATERIALS AND METHODS: In this prospective, randomized control trial, 50 adult patients with septic shock were randomized into two groups. Group I received a combination of injection terlipressin 0.02 µg/kg/min (fixed dose) infusion and injection norepinephrine 0.01 µg/kg/min infusion and group II received injection norepinephrine 0.01 µg/kg/min infusion alone. Dose of noradrenaline in both the groups was titrated to achieve the target MAP of 65–70 mm Hg. The data collected were the dose of norepinephrine required to maintain an MAP of above 65 mm Hg, urine output, serum lactate, procalcitonin level, C-reactive protein, sequential organ failure assessment (SOFA) score, total duration of vasopressor support, and incidences of the adverse effects. RESULTS: The norepinephrine dose in group I vs group II at 12 hours was found to be 0.141 ± 0.067 vs 0.374 ± 0.096 µg/kg/min (p ≤0.005). The serum lactate was lower, and urine output was higher in group I than group II (p <0.05). Group I had a significantly greater reduction in SOFA score in 12 hours than group II. Group I patient also had a significant decrease in the duration of vasopressor administration than group II patients being discharged from the ICU. However, there was no difference in the mortality between the two groups during their ICU stay. CONCLUSION: A low-dose continuous infusion of terlipressin and norepinephrine could help attain early resuscitation goals for managing patients with septic shock. HOW TO CITE THIS ARTICLE: Sahoo P, Kothari N, Goyal S, Sharma A, Bhatia PK. Comparison of Norepinephrine and Terlipressin vs Norepinephrine Alone for Management of Septic Shock: A Randomized Control Study. Indian J Crit Care Med 2022;26(6):669–675. Jaypee Brothers Medical Publishers 2022-06 /pmc/articles/PMC9237141/ /pubmed/35836627 http://dx.doi.org/10.5005/jp-journals-10071-24231 Text en Copyright © 2022; The Author(s). https://creativecommons.org/licenses/by-nc/4.0/© The Author(s). 2022 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Article
Sahoo, Pallavi
Kothari, Nikhil
Goyal, Shilpa
Sharma, Ankur
Bhatia, Pradeep K
Comparison of Norepinephrine and Terlipressin vs Norepinephrine Alone for Management of Septic Shock: A Randomized Control Study
title Comparison of Norepinephrine and Terlipressin vs Norepinephrine Alone for Management of Septic Shock: A Randomized Control Study
title_full Comparison of Norepinephrine and Terlipressin vs Norepinephrine Alone for Management of Septic Shock: A Randomized Control Study
title_fullStr Comparison of Norepinephrine and Terlipressin vs Norepinephrine Alone for Management of Septic Shock: A Randomized Control Study
title_full_unstemmed Comparison of Norepinephrine and Terlipressin vs Norepinephrine Alone for Management of Septic Shock: A Randomized Control Study
title_short Comparison of Norepinephrine and Terlipressin vs Norepinephrine Alone for Management of Septic Shock: A Randomized Control Study
title_sort comparison of norepinephrine and terlipressin vs norepinephrine alone for management of septic shock: a randomized control study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9237141/
https://www.ncbi.nlm.nih.gov/pubmed/35836627
http://dx.doi.org/10.5005/jp-journals-10071-24231
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