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Rodrı́guez-Núñez, Antonio; López‐Herce, Jesús; Gil-Antón, Javier; Hernández, Arturo; Rey, Corsino

doi:10.1186/cc3984

Cited by 61 publications

(13 citation statements)

References 42 publications

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“…Eleven small LOE 4 pediatric case series 425–435 showed improved hemodynamics but not survival when vasopressin or terlipressin was administered to children with refractory, vasodilatory, septic shock.…”

Section: Arrhythmia Therapypeds-030mentioning

confidence: 99%

Part 10: Pediatric Basic and Advanced Life Support

Kleinman

Caen

Chameides³

et al. 2010

Circulation

183

184

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Note From the Writing Group: Throughout this article, the reader will notice combinations of superscripted letters and numbers (eg, “Family Presence During ResuscitationPeds-003”). These callouts are hyperlinked to evidence-based worksheets, which were used in the development of this article. An appendix of worksheets, applicable to this article, is located at the end of the text. The worksheets are available in PDF format and are open access.

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Section: Arrhythmia Therapypeds-030mentioning

confidence: 99%

Part 10: Pediatric Basic and Advanced Life Support

Kleinman

Caen

Chameides³

et al. 2010

Circulation

183

184

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“…Given such biological properties and efficacy in the hepatorenal syndrome, intermittent intravenous boluses of TP have been used to restore blood pressure in septic shock patients [4] , [10] . However, serious adverse events have been reported and there is uncertainty over its ability to replicate the potential beneficial effects of AVP [11] – [13] and its safety in this setting. Such uncertainty derives, in part, from the lack of controlled experimental data on its regional effects.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Terlipressin on Regional Hemodynamics and Kidney Function in Experimental Hyperdynamic Sepsis

et al. 2012

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Background and AimsAlthough terlipressin (TP) may improve renal function in cirrhotic patients, its use in sepsis remains controversial due to concerns about regional ischemia. We investigated the effects of TP on regional hemodynamics and kidney function in experimental hyperdynamic sepsis.MethodsWe studied thirteen merino ewes in a university physiology laboratory using a randomized controlled cross over design. We implanted flow probes around the pulmonary, circumflex coronary, superior mesenteric, renal and iliac arteries. We injected live Escherichia coli and induced hyperdynamic sepsis. We treated animals with either bolus vehicle or a single dose of TP (sTP = 1 mg). In a second group, after 1 mg of TP, two additional bolus injections (mTP) of 0.5 mg were given at 2 hourly intervals.Main ResultssTP (1 mg) significantly increased mean arterial pressure (MAP) (74 to 89 mmHg; P<0.0001) creatinine clearance (31 to 85 mL/min; P<0.0001) and urine output (24 to 307 mL/hr) (P<0.0001). However, it decreased CO (5.7 to 3.9 L/min; p<0.0001), coronary blood flow (CBF) (43 to 32 mL/min; p<0.0001) and mesenteric blood flow (MBF) (944 to 625 mL/min; p = 0.004) and increased blood lactate (2.1 to 4.0 mmol/L; p<0.0001). Extra doses of TP caused little additional effect.ConclusionsIn hyperdynamic sepsis, bolus TP transiently improves MAP and renal function, but reduces CO, CBF and MBF, and increases blood lactate. Caution should be applied when prescribing bolus TP in septic patients at risk of coronary or mesenteric ischemia.

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“…In some patients, in whom systemic vascular resistance is very low despite norepinephrine administration, vasopressin, and terlipressin were used, but no benefit from these drugs has been shown in randomized studies [56][57][58][59][60]. In patients with low cardiac output, but high systemic vascular resistance, vasodilators such as…”

Section: Inotropes Vasopressors and Vasodilatorsmentioning

confidence: 99%

Sepsis in Children

Öncel¹

2017

Intensive Care

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Sepsis is systemic inflammatory response syndrome due to a documented or suspected infection. Causative agents of sepsis include group B streptococcus, Escherichia coli, and Listeria monocytogenes in infants younger than 2 months, and communityacquired organisms. Bacteremia may ensue in patients whose defense mechanisms have become vulnerable due to many factors. Sepsis and septic shock can be viewed as clinical pictures, which develop as consequences of proinflammatory processes/ cytokines leading to a state that cannot be restrained by anti-inflammatory processes/ cytokines. As yet, a cytokine, which is uniquely associated with severe sepsis and septic shock and can be used as a biomarker, has not been discovered. Sepsis is a cytokine storm, which may adversely affect almost any organ system. Whether there is an association between the severity of sepsis or septic shock and cytokine gene polymorphisms is an important field of study. Mottled skin and prolongation of capillary refill time may help the physician recognize septic shock before hypotension emerges. The management of severe sepsis and septic shock involves (1) the hemodynamic support, (2) inotropes, vasopressors, and vasodilators, (3) antimicrobial therapy, (4) transfusions, and (5) corticosteroids as indicated. Hospital mortality of pediatric sepsis is 2-10%.

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Untitled

Cited by 61 publications

References 42 publications

Part 10: Pediatric Basic and Advanced Life Support

Part 10: Pediatric Basic and Advanced Life Support

The Effects of Terlipressin on Regional Hemodynamics and Kidney Function in Experimental Hyperdynamic Sepsis

Sepsis in Children

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