Trial reportCritical care (London, England)2025
Adjunctive terlipressin versus placebo in the treatment of refractory septic shock: a randomized, placebo-controlled trial.
Trial report in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Early Methylene Blue for Mortality Reduction in High-Dose VasoPREssor-Dependent Septic Shock (EMPRESS): protocol for a multicenter randomized controlled trial.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTerlipressin’s role as an adjunctive vasopressor in septic shock remains controversial. We aimed to evaluate the efficacy of terlipressin versus placebo as an additional vasopressor in refractory septic shock.
methodsWe conducted a single-center, prospective, double-blind, randomized controlled trial in a medical intensive care unit. Adult patients with septic shock requiring norepinephrine > 0.2 mcg/kg/min or epinephrine were randomly assigned (1:1) to receive terlipressin or placebo. The primary outcome was the proportion of patients achieving mean arterial pressure ≥ 65 mmHg with total catecholamine equivalent dose below 0.2 mcg/kg/min at 6 h after randomization.
resultsA total of 130 patients were enrolled: 66 in the terlipressin group and 64 in the placebo group. Baseline characteristics were comparable. The median (interquartile range) baseline norepinephrine equivalent dose was 0.39 (0.29 − 0.73) mcg/kg/min for terlipressin versus 0.39 (0.27 − 0.62) mcg/kg/min for placebo. Pneumonia (57.6% vs 48.4%) and intra-abdominal infection (21.2% vs 23.4%) were the most common etiologies in the terlipressin and placebo arms, respectively. Significantly more patients met the primary outcome with terlipressin than with placebo (22.7% vs 9.4%; relative risk [RR] = 1.53, 95% confidence interval [CI] = 1.09–2.14; P = 0.039). The 28-day mortality was 60.6% in the terlipressin group versus 64.1% in the placebo group (RR = 0.93, 95% CI = 0.66–1.31; P = 0.68). Digital ischemia occurred in 28.8% versus 27.4% (P = 0.86).
conclusionsAmong patients with refractory septic shock, adjunctive terlipressin reduced the proportion of patients requiring high-dose catecholamines at 6 h, without significantly altering mortality or digital ischemia risk.
trial registrationClinicaltrials.gov (NCT 04339868). The registration date was April 7, 2020.
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