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Terlipressin as rescue treatment of refractory shock in a neonate


Luca Filippi, M.D., Neonatal Intensive Care Unit – Department of Critical Care Medicine – A. Meyer University Children's Hospital, Viale Pieraccini, 24 I-50134 Florence, Italy. Tel: +39-(0)55-5662434 | Fax +39-(0)55-5662400 | Email:


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.

Conclusion: 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.