315915

Comparison Between Terlipressin and Catecholamine Infusion in the Management of Vasodilatory Shock: A Meta-Analysis of Randomized Controlled Trials

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Last updated: 04 Jan 2025

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Abstract

Background: Vasodilatory shock is a grave sign of cardiovascular failure. The use of vasocative infusions is indicated when fluid resuscitation fails to restore adequate arterial pressure and tissue perfusion. Therefore, the proper management of clinically diverse shock states necessitates thorough knowledge of the mechanisms of action of vasoconstrictor drugs. Objectives: To compare between terlipressin and catecholamine infusion in the management of vasodilatory shock. Study design: Meta-analysis Methods: Online databases (PubMed, Embase, BioMed, and the Cochrane Central Register of Controlled trials) were utilized for randomized studies ever performed in humans with Terlipressin in any clinical setting. Results: Twelve trials were included, involving a total of 1063 patients. The risk of bias was low. The meta-analysis found that there was no significant reduction in mortality. There was a significant reduction in heart rate, a significant increase in cardiac index, SVRI and UOP. There was no significant change in the rest of the hemodynamic variables among the included studies (MAP, SVI, PAOP, MPAP, PVRI, LVSWI, RVSWI and RAP). There was a significant decrease in IDO2, a significant increase in pH and a significant decrease in BE. There was no significant change in PO2 and PCO2 among the studies. There was a significant reduction in serum lactate and hemoglobin, while no significant change was observed in INR. Conclusion: This meta-analysis showed no significance of terlipressin over catecholamines in reducing mortality rates, however, terlipressin is associated with reduction of HR, increase in SVRI, reduction of serum lactate level and increase in UOP.

DOI

10.21608/bmfj.2023.216960.1837

Keywords

Terlipressin, catecholamines, Meta-Analysis, randomized trials, vasodilatory shock

Authors

First Name

Enas

Last Name

Mahdy

MiddleName

Wageih

Affiliation

Assistant Professor of Anesthesia & Intensive Care Faculty of Medicine - Benha University

Email

ewm01221592827@gmail.com

City

-

Orcid

-

First Name

Ahmed

Last Name

Abd El-Hamid

MiddleName

Mostafa

Affiliation

Department of anesthesia & intensive care, Faculty of Medicine, Benha University

Email

ahmedmostafa@fmed.bu.edu.eg

City

-

Orcid

-

First Name

Salwa

Last Name

Awad Eltahawy

MiddleName

Abbas

Affiliation

Department of Critical Care Medicine, Faculty of Medicine, Benha University

Email

salwa21abbas@gmail.com

City

-

Orcid

-

First Name

Samah

Last Name

Mohammed Ebaed

MiddleName

Bahy

Affiliation

Departmentof clinical pharmacology , Faculty of Medicine, Benha University

Email

samahbahi2005@gmail.com

City

-

Orcid

-

Volume

40

Article Issue

2

Related Issue

43348

Issue Date

2023-09-01

Receive Date

2023-06-11

Publish Date

2023-09-01

Page Start

578

Page End

596

Print ISSN

1110-208X

Online ISSN

2357-0016

Link

https://bmfj.journals.ekb.eg/article_315915.html

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https://bmfj.journals.ekb.eg/service?article_code=315915

Order

24

Type

Review Article

Type Code

920

Publication Type

Journal

Publication Title

Benha Medical Journal

Publication Link

https://bmfj.journals.ekb.eg/

MainTitle

Comparison Between Terlipressin and Catecholamine Infusion in the Management of Vasodilatory Shock: A Meta-Analysis of Randomized Controlled Trials

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Type

Article

Created At

24 Dec 2024