• Pediatr Crit Care Me · Mar 2004

    Case Reports

    Terlipressin as rescue therapy for intractable hypotension during neonatal septic shock.

    • Ilan Matok, Leah Leibovitch, Amir Vardi, Miriam Adam, Marina Rubinshtein, Zohar Barzilay, and Gideon Paret.
    • Department of Pharmacy Services, Safra Children's Hospital, The Chaim Sheba Medical Center, Tel Hashomer and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
    • Pediatr Crit Care Me. 2004 Mar 1;5(2):116-8.

    ObjectiveTo report the successful use of terlipressin in an 8-day-old infant for treatment of intractable hypotension caused by septic shock.DesignDescriptive case report.SettingAn 18-bed pediatric intensive care unit at a tertiary care children's hospital.PatientAn 8-day-old child with intractable hypotension due to septic shock after heart surgery.InterventionsGeneral supportive intensive care including mechanical ventilatory support, volume replacement, and inotropic support with dopamine 20 microg.kg(-1).min(-1), milrinone 0.75 microg.kg(-1).min(-1), and epinephrine 0.8 microg.kg(-1).min(-1).Measurements And Main ResultsTerlipressin (7 microg/kg per dose twice daily) was added as rescue therapy because of profound intractable hypotension. Shortly after the beginning of treatment, blood pressure and perfusion dramatically improved.ConclusionsThere is circumstantial evidence that the administration of terlipressin caused the increase in blood pressure. We suggest that terlipressin should be considered as rescue therapy when high-dose catecholamine therapy does not result in sufficient perfusion pressure. Further investigation is needed to prove terlipressin's effectiveness and safety in infants and children.

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