Terlipressin bolus induces systemic vasoconstriction in septic shock*

Abstract

OBJECTIVE: To report the use of a synthetic, long-acting, vasopressin analog, terlipressin, as an effective vasoconstrictor in septic shock. DESIGN: Case report. SETTING: A 22-bed pediatric intensive care unit in a tertiary referral center. PATIENT: An 11-yr-old male with multiple-organism Gram-negative septic shock with high normal cardiac output as assessed by pulse contour analysis and low systemic vascular resistance despite norepinephrine infusion. INTERVENTION: Two peripherally administered doses of terlipressin (0.5 mg). MEASUREMENTS AND MAIN RESULTS: Each dose of terlipressin was associated with a rapid increase in systemic vascular resistance, despite weaning and discontinuation of norepinephrine infusion from 0.15 microg.kg(-1).min(-1) lasting approximately 6 hrs. CONCLUSION: Terlipressin may be useful for sepsis-induced vasodilation.