Comparison of first-line and second-line terlipressin versus sole norepinephrine in fulminant ovine septic shock

Abstract The Surviving Sepsis Guidelines suggest the use of vasopressin in case of catecholamine-refractory septic shock. Terlipressin (TP) as a V1-selective AVP analogue is a potential alternative, though data regarding the first-line administration in septic shock are scarce. The present study exp...

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Autores principales:	Tim G. Kampmeier, Philip H. Arnemann, Michael Hessler, Laura M. Seidel, Karsten Becker, Andrea Morelli, Sebastian W. Rehberg, Christian Ertmer
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3a92b5e99125456189812fba95394305
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spelling	oai:doaj.org-article:3a92b5e99125456189812fba953943052021-12-02T12:31:56ZComparison of first-line and second-line terlipressin versus sole norepinephrine in fulminant ovine septic shock10.1038/s41598-018-25570-x2045-2322https://doaj.org/article/3a92b5e99125456189812fba953943052018-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-25570-xhttps://doaj.org/toc/2045-2322Abstract The Surviving Sepsis Guidelines suggest the use of vasopressin in case of catecholamine-refractory septic shock. Terlipressin (TP) as a V1-selective AVP analogue is a potential alternative, though data regarding the first-line administration in septic shock are scarce. The present study explored and compared the effects of first-line vs. second-line infusion of TP or sole norepinephrine regarding organ function, fluid and norepinephrine requirements and survival in fulminant ovine septic shock. Peritoneal sepsis was induced in 23 ewes after laparotomy and faecal withdrawal from the caecum. After onset of shock, causal and supportive sepsis therapy (antibiotics, peritoneal lavage, fluids and open-label norepinephrine) was performed in all animals. Concurrently, animals were randomized to receive 0.9% sodium chloride (control group) or TP (2 µg∙kg−1∙h−1, first-line group) after shock onset. In the second-line TP group, TP (2 µg∙kg−1∙h−1) was started once norepinephrine requirements exceeded 0.5 µg∙kg−1∙min−1. No significant differences were found between groups regarding survival, haemodynamics as well as fluid- and catecholamine-requirements. Kidney function and electron microscopic kidney injury were comparable between groups. In the present model of fulminant ovine septic shock, first-line TP infusion had no significant effect on fluid and norepinephrine requirements or organ dysfunction as compared to second-line TP infusion or placebo.Tim G. KampmeierPhilip H. ArnemannMichael HesslerLaura M. SeidelKarsten BeckerAndrea MorelliSebastian W. RehbergChristian ErtmerNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-11 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Tim G. Kampmeier Philip H. Arnemann Michael Hessler Laura M. Seidel Karsten Becker Andrea Morelli Sebastian W. Rehberg Christian Ertmer Comparison of first-line and second-line terlipressin versus sole norepinephrine in fulminant ovine septic shock
description	Abstract The Surviving Sepsis Guidelines suggest the use of vasopressin in case of catecholamine-refractory septic shock. Terlipressin (TP) as a V1-selective AVP analogue is a potential alternative, though data regarding the first-line administration in septic shock are scarce. The present study explored and compared the effects of first-line vs. second-line infusion of TP or sole norepinephrine regarding organ function, fluid and norepinephrine requirements and survival in fulminant ovine septic shock. Peritoneal sepsis was induced in 23 ewes after laparotomy and faecal withdrawal from the caecum. After onset of shock, causal and supportive sepsis therapy (antibiotics, peritoneal lavage, fluids and open-label norepinephrine) was performed in all animals. Concurrently, animals were randomized to receive 0.9% sodium chloride (control group) or TP (2 µg∙kg−1∙h−1, first-line group) after shock onset. In the second-line TP group, TP (2 µg∙kg−1∙h−1) was started once norepinephrine requirements exceeded 0.5 µg∙kg−1∙min−1. No significant differences were found between groups regarding survival, haemodynamics as well as fluid- and catecholamine-requirements. Kidney function and electron microscopic kidney injury were comparable between groups. In the present model of fulminant ovine septic shock, first-line TP infusion had no significant effect on fluid and norepinephrine requirements or organ dysfunction as compared to second-line TP infusion or placebo.
format	article
author	Tim G. Kampmeier Philip H. Arnemann Michael Hessler Laura M. Seidel Karsten Becker Andrea Morelli Sebastian W. Rehberg Christian Ertmer
author_facet	Tim G. Kampmeier Philip H. Arnemann Michael Hessler Laura M. Seidel Karsten Becker Andrea Morelli Sebastian W. Rehberg Christian Ertmer
author_sort	Tim G. Kampmeier
title	Comparison of first-line and second-line terlipressin versus sole norepinephrine in fulminant ovine septic shock
title_short	Comparison of first-line and second-line terlipressin versus sole norepinephrine in fulminant ovine septic shock
title_full	Comparison of first-line and second-line terlipressin versus sole norepinephrine in fulminant ovine septic shock
title_fullStr	Comparison of first-line and second-line terlipressin versus sole norepinephrine in fulminant ovine septic shock
title_full_unstemmed	Comparison of first-line and second-line terlipressin versus sole norepinephrine in fulminant ovine septic shock
title_sort	comparison of first-line and second-line terlipressin versus sole norepinephrine in fulminant ovine septic shock
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/3a92b5e99125456189812fba95394305
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Comparison of first-line and second-line terlipressin versus sole norepinephrine in fulminant ovine septic shock

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