Role of arginine vasopressin and terlipressin as first-line vasopressor agents in fulminant ovine septic shock

Abstract

This study provides evidence that the effects of low-dose TP differ from those of AVP, not only as TP has a longer half life, but also because of different mechanisms of action. Although low-dose TP infusion may be superior to sole norepinephrine or AVP therapy in septic shock, the safety of this therapeutic approach should be determined in more detail.

Effects of two different dosing regimens of terlipressin on organ functions in ovine endotoxemia

“…Interestingly, vascular leakage was markedly attenuated in sheep treated with continuous low-dose TP infusion. This finding is in agreement with a previous report comparing continuous AVP versus continuous TP infusion in sheep with peritonitis-induced septic shock [17]. In the latter study, extravasation of proteins and fluids was attenuated by TP infusion, while AVP had no beneficial effects on microvascular leakage.…”

“…Troponin I was measured instead of creatinine kinase because previous experiments demonstrated troponin I to be a reliable marker of myocardial injury in sheep [17].…”

Vasopressin and Its Immune Effects in Septic Shock

“…V1 receptors appear to decrease edemagenesis in a smoke inhalation, bacterial exposure acute lung injury model [66] . Terlipressin is a vasopressin analogue with greater V1 receptor specificity.…”

A randomized, placebo-controlled, double-blind study to confirm the reversal of hepatorenal syndrome type 1 with terlipressin: the REVERSE trial design

“…31 The postulated mechanism of action for this effect is that the stimulation of V1 receptors in vascular smooth muscle leads to an increase in cytoplasmic ionized calcium via the phosphatidylinositol biphosphate cascade. [31][32][33] In HRS type 1, the effect that terlipressin promulgates is mediated by vasoconstriction of the splanchnic arterial blood vessels reducing blood flow to the system, thereby providing indirect volume expansion. 3 Stimulation of V2 receptors responsible for an antidiuretic effect is less desirable in HRS.…”