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BioMed Central, Critical Care, S3(17), 2013

DOI: 10.1186/cc12640

BioMed Central, Critical Care, 4(16), 2012

DOI: 10.1186/cc11469

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Vasopressin and terlipressin in adult vasodilatory shock: a systematic review and meta-analysis of nine randomized controlled trials

Journal article published in 2012 by Ary Serpa Neto, Pereira Vgm, Cardoso So, M. de Oliveira Prado Pasqualucci, Ary Serpa Neto, Antônio P. Nassar ORCID, Sérgio O. Cardoso, José A. Manetta, Jose A. Manettta, Manetta Ja, Victor Gm Pereira, Daniel C. Espósito, Espósito Dc, Maria Ct Damasceno, James A. Russell
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Abstract Introduction Catecholamines are the most used vasopressors in vasodilatory shock. However, the development of adrenergic hyposensitivity and the subsequent loss of catecholamine pressor activity necessitate the search for other options. Our aim was to evaluate the effects of vasopressin and its analog terlipressin compared with catecholamine infusion alone in vasodilatory shock. Methods A systematic review and meta-analysis of publications between 1966 and 2011 was performed. The Medline and CENTRAL databases were searched for studies on vasopressin and terlipressin in critically ill patients. The meta-analysis was limited to randomized controlled trials evaluating the use of vasopressin and/or terlipressin compared with catecholamine in adult patients with vasodilatory shock. The assessed outcomes were: overall survival, changes in the hemodynamic and biochemical variables, a decrease of catecholamine requirements, and adverse events. Results Nine trials covering 998 participants were included. A meta-analysis using a fixed-effect model showed a reduction in norepinephrine requirement among patients receiving terlipressin or vasopressin infusion compared with control (standardized mean difference, -1.58 (95% confidence interval, -1.73 to -1.44); P