Filippi Luca, Poggi Chiara, Serafini Lisa, Fiorini Patrizio
Neonatal Intensive Care Unit, Department of Critical Care Medicine, A. Meyer University Children's Hospital, Florence, Italy.
Acta Paediatr. 2008 Apr;97(4):500-2. doi: 10.1111/j.1651-2227.2008.00681.x. Epub 2008 Feb 27.
Patients with septic shock may develop refractory hypotension despite maximal inotropic support with impairment of clinical outcome. Terlipressin, a long-acting vasopressin analogue, is reported to be effective as rescue treatment of refractory septic shock in adult and paediatric patients, while clinical experience in neonates is definitely scarce. We report a neonate with systemic inflammatory response syndrome after surgery for abdominal neuroblastoma who received terlipressin as rescue treatment after failure of volume load and catecholamines. Terlipressin promptly reversed hypotension and improved tissue perfusion without adverse effects.
Terlipressin appears an effective rescue treatment in patients with refractory vasodilatory septic shock. Further studies are required to assess its efficacy and safety in neonatal population.
尽管给予最大剂量的血管活性药物支持,感染性休克患者仍可能出现难治性低血压,影响临床预后。特利加压素是一种长效血管加压素类似物,据报道在成人和儿童患者中作为难治性感染性休克的抢救治疗有效,而新生儿的临床经验肯定很少。我们报告了一名腹部神经母细胞瘤手术后出现全身炎症反应综合征的新生儿,在容量负荷和儿茶酚胺治疗失败后接受特利加压素作为抢救治疗。特利加压素迅速逆转了低血压并改善了组织灌注,且无不良反应。
特利加压素似乎是难治性血管扩张性感染性休克患者的一种有效抢救治疗方法。需要进一步研究评估其在新生儿群体中的疗效和安全性。