TERLIPRESSIN COMBINED WITH NOREPINEPHRINE IN THE TREATMENT OF SEPTIC SHOCK: A SYSTEMATIC REVIEW

• Published in: Shock (Augusta, Ga.) Ga.), 2023-10, Vol.60 (4), p.479-486
• Main Authors: Mao, Fengkai, Liang, Dongcheng, Tang, Zewen, Xu, Yuxuan, Lin, Leqing
• Format: Article
• Language: English
• Subjects: Adult; Combined Modality Therapy; Humans; Lypressin - therapeutic use; Norepinephrine - therapeutic use; Shock, Septic - drug therapy; Terlipressin - therapeutic use; Vasoconstrictor Agents - therapeutic use
• ISSN: 1073-2322; 1540-0514
• DOI: 10.1097/SHK.0000000000002204

Objective: The objective of this study was to provide an in-depth analysis of the advantages and potential research directions concerning the utilization of terlipressin (TP) in combination with norepinephrine (NE) for the management of septic shock. Methods: A systematic search was conducted across five major electronic databases, namely, PubMed, Cochrane, Embase, ScienceDirect, and MEDLINE, using the Boolean method. The search encompassed articles published until May 22, 2023. Randomized controlled trials investigating the efficacy of TP combined with NE in the treatment of patients with septic shock were considered for inclusion. Results: A total of seven trials met the inclusion criteria. The combination therapy of TP and NE exhibited potential benefits in the treatment of adult patients suffering from septic shock. Furthermore, the concurrent administration of TP with NE demonstrated improvements in cardiac output and central venous pressure. However, it is important to acknowledge the presence of certain risks and potential adverse events, including an elevated risk of peripheral ischemia. Conclusions: The available evidence supports the notion that early combination therapy involving NE and TP holds promise in terms of reducing the required dosage of NE, enhancing renal perfusion, and improving microcirculation in patients diagnosed with septic shock.