6/28/23, 11:02 PM Liu Pathway Feedback Search Clinical Topics Home Studies Liu Liu Disease Sepsis and septic shock Trial question What is the role of terlipressin in patients with septic shock? Study design Multi-center Double blinded RCT Population Characteristics of study participants 37.2% female N = 617 62.8% male 617 patients (195 female, 331 male) Inclusion criteria: patients in the ICU with septic shock Key exclusion criteria: unstable coronary syndrome, previous use of terlipressin for arterial BP support before entry, malignancy or other irreversible disease with poor prognosis, acute mesenteric ischemia Interventions N=312 terlipressin (20-160 g/hour with maximum infusion rate of 4 mg/day before open-label vasopressors) N=305 norepinephrine (4-30 g/min before open-label vasopressors) Primary outcome https://web.pathway.md/studies/rec97MM7zG2CnomMS 1/2 6/28/23, 11:02 PM Liu Pathway Death at day 28 40.0 % 40 38 30.0 % 20.0 % 10.0 % No significant difference 0.0 % Terlipressin Norepinephrine No significant difference in death at day 28 (40% vs. 38%; RR 1.053, 95% CI 0.74 to 1.5) Secondary outcomes No significant difference in change in SOFA score on day 7 (-7 vs. -6; AD -1, 95% CI -2.27 to 0.27) No significant difference in days alive and free of vasopressor (15.5 days vs. 14.66 days; AD 0.84 days, 95% CI -1.19 to 2.87) Safety outcomes No significant differences in acute myocardial infarction or ischemia, life-threatening arrhythmia, hyponatremia, acute mesenteric ischemia. Significant differences in serious adverse events (30% vs. 12%), digital ischemia (12.6% vs. 0.35%), diarrhea (2.72% vs. 0.35%). Conclusion In patients in the ICU with septic shock, terlipressin was not superior to norepinephrine with respect to death at day 28. Reference Zi-Meng Liu, Juan Chen, Qiuye Kou et al. Terlipressin versus norepinephrine as infusion in patients with septic shock: a multicentre, randomised, double-blinded trial. Intensive Care Med. 2018 Nov;44(11):1816-1825. Open reference URL https://web.pathway.md/studies/rec97MM7zG2CnomMS 2/2