If you are experiencing problems downloading PDF or HTML fulltext, our helpdesk recommend clearing your browser cache and trying again. If you need help in clearing your cache, please click here . Still need help? Email help@ingentaconnect.com

Terlipressin increased the concentration ofl-lactate in the rectal lumen in a patient with septic shock

$48.00 plus tax (Refund Policy)

Download / Buy Article:

Abstract:

Terlipressin – a long-acting analogue of vasopressin – has been described to restore blood pressure in patients with catecholamine-resistant septic shock without obvious complications. We administered low-dose terlipressin (a single i.v.-bolus of 0.5 mg) to a patient with severe, hyperdynamic septic shock requiring high dosage of noradrenalin. After terlipressin the dose of noradrenalin could be reduced by 2/3 to obtain the same blood pressure. Two hours after terlipressin, the cardiac index had decreased from 6.2 to 3.3 l min−1 m−2 and the concentration of L-lactate in the rectal lumen, as assessed by equilibrium dialysis, increased from 3.6 to 7.2 mmol l−1. In contrast, the systemic concentration of L-lactate was unaffected around 2.8 mmol l−1. After 8 h the effect of terlipressin started to decline, and after an additional 12 h the systemic haemodynamics, dose of noradrenalin and concentrations of rectal and systemic L-lactate were the same as prior to the administration of terlipressin. As a strong vasopressor, terlipressin may have further impaired the metabolic dysfunction in the rectal mucosa either directly via vasoconstriction of mucosal vessels or through decreased cardiac output in this patient with noradrenalin-treated septic shock.

Keywords: Cardiac output; dialysis; intestinal mucosa; lactic acid; sepsis; shock; vasopressins

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.0001-5172.2004.00442.x

Affiliations: 1: Rigshospitalet and 2: Herlev Hospital, University of Copenhagen, Copenhagen, Denmark

Publication date: September 1, 2004

Related content

Tools

Favourites

Share Content

Access Key

Free Content
Free content
New Content
New content
Open Access Content
Open access content
Subscribed Content
Subscribed content
Free Trial Content
Free trial content
Cookie Policy
X
Cookie Policy
ingentaconnect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more