Continuos Terlipressin Infusion in Septic Shock

• SOFA score [ Time Frame: 7 days ] [ Designated as safety issue: No ]
  SOFA score was measured on day0-7 after the start of the infusion in both groups
• days alive and free of vasopressor [ Time Frame: during the first 28 days after the start of the infusion ] [ Designated as safety issue: No ]
  Days of vasopressor were recorded after the start of the infusion in both groups.
• 90-day mortality [ Time Frame: 90 days after the start of the infusion ] [ Designated as safety issue: No ]

The purpose of this study is to evaluate the efficacy of terlipressin for treating septic shock.

Septic shock is the most common cause of death in intensive care units and has a mortality rate of 40 to 60%.Vasopressin is commonly used as an adjunct to catecholamines to support blood pressure in refractory septic shock.Recently small sample clinical study suggest that Terlipressin,a vasopressin analogues, was effective in reversing sepsis-induced arterial hypotension and in reducing norepinephrine requirements.But its effect on mortality is unknown.Invesgators hypothesized that Terlipressin as compared with norepinephrine would decrease mortality among patients with septic shock.

• Drug: Terlipressin
  continuous infusion of terlipressin (0.66ug/min-2.66ug/min) ,dosage modified acorrding to blood pressure
• Drug: Norepinephrine
  continuous infusion with dose 7.5ug/min-30ug/min,modified acorrding to blood pressure

• Experimental: terlipressin
  Intervention: Drug: Terlipressin
• Active Comparator: norepinephrine
  Intervention: Drug: Norepinephrine

Inclusion Criteria:

• Septic shock was defined by the presence of two or more diagnostic criteria for the systemic inflammatory responsesyndrome, proven or suspected infection, and hypotension (exclusion of hypertention other than sepsis)

Exclusion Criteria:

• organ transplantation;
• pregancy or breast-feeding;
• malignancy or other irreversible disease or condition for which has a poor prognosis;
• acute coronary syndrome;
• chronic heart failure(NYHA III or IV)/cardiogenic shock;
• acute mesenteric ischemia;
• greater than 48 hours had elapsed since the patient met entry criteria;
• estimation of incomplite treament due to financial problem;
• use of terlipressin for blood pressure support before entry;
• Raynaud's phenomenon, systemic sclerosis or vasospastic diathesis;
• registration of other clinical trial which will affect the outcome of the current study

• Guangdong Province, Department of Science and Technology
• Second Affiliated Hospital, Sun Yat-Sen University
• Sixth Affiliated Hospital, Sun Yat-sen University
• Chinese PLA General Hospital
• Beijing 302 Hospital
• Shanghai Changzheng Hospital
• Wuhan Union Hospital, China
• Xiangya Hospital of Central South University
• Anhui Provincial Hospital
• First Affiliated Hospital Bengbu Medical College
• Guangxi Medical University
• Jinling Hospital, China
• West China Hospital
• Hainan People's Hospital
• Xi’an Jiaotong University College of Medicine
• China Medical University, China
• First People's Hospital of Foshan
• Zhuhai People's Hospital