A
bstract
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.
Volatile organic compounds including benzene, toluene, ethyl benzene, and xylene (BTEX) in the atmosphere have severe health and environmental implications. These variables are trace elements in the atmosphere. There are not enough measurement and analysis studies related to atmospheric BTEX variation globally, and studies are even less in developing countries like India. The present study analyses BTEX variations over an eastern Indian site, Bhubaneswar. The continuous measurement of BTEX is first of its kind over Bhubaneswar. The study analyses 2 years of BTEX data (2017–2018), and attempts to find the relation with meteorological parameters, the significance of the ratio between components, along with the analysis of transported air masses. To account for the pattern of emissions in association with BTEX variability over Bhubaneswar, we have also developed emission details from the transportation sector for the year 2018 and analyzed the emission patterns of CO and NOx for the year 2018. The results indicated that BTEX concentrations are maintained at the site via transportation from other regions, with significant local generation of BTEX, which is smaller in comparison to the transported emission.
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