Background: Vasodilatory shock is a grave sign of cardiovascular failure. The use of vasocative infusions is indicated when fluid resuscitation fails to restore adequate arterial pressure and tissue perfusion. Therefore, the proper management of clinically diverse shock states necessitates thorough knowledge of the mechanisms of action of vasoconstrictor drugs. Objectives: To compare between terlipressin and catecholamine infusion in the management of vasodilatory shock. Study design: Meta-analysis Methods: Online databases (PubMed, Embase, BioMed, and the Cochrane Central Register of Controlled trials) were utilized for randomized studies ever performed in humans with Terlipressin in any clinical setting. Results: Twelve trials were included, involving a total of 1063 patients. The risk of bias was low. The meta-analysis found that there was no significant reduction in mortality. There was a significant reduction in heart rate, a significant increase in cardiac index, SVRI and UOP. There was no significant change in the rest of the hemodynamic variables among the included studies (MAP, SVI, PAOP, MPAP, PVRI, LVSWI, RVSWI and RAP). There was a significant decrease in IDO2, a significant increase in pH and a significant decrease in BE. There was no significant change in PO2 and PCO2 among the studies. There was a significant reduction in serum lactate and hemoglobin, while no significant change was observed in INR. Conclusion: This meta-analysis showed no significance of terlipressin over catecholamines in reducing mortality rates, however, terlipressin is associated with reduction of HR, increase in SVRI, reduction of serum lactate level and increase in UOP. |
