A Comparative Assessment of Norepinephrine and Terlipressin in the Management of Hepatorenal Syndrome
- 1. Associate Professor, Department of Medicine, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India
- 2. PG Student, Department of Medicine, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India
Description
Aim: Assessment of norepinephrine and terlipressin in the management of Hepatorenal Syndrome. Materials and methods: A total of 40 patients with HRS type 1, presenting at the Department of Medicine, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India, were prospectively evaluated. Patients were randomized to either terlipressin or noradrenaline group i.e. half for terlipressin (group A) and half for noradrenaline (group B). Patients in either group received treatment with terlipressin or noradrenaline with 20 g albumin/day. Patients in group A received terlipressin as an intravenous bolus of 0.5 mg every 6 h. Patients in group B received a continuous infusion of noradrenaline at an initial dose of 0.5 mg/h, designed to achieve an increase in MAP of at least 10 mmHg or an increase in 4-h urine output of more than 200 ml. All patients were admitted for 15 days in hospital and followed-up to 30 days. Clinical and biochemical parameters were assessed at baseline, and day 15. An arterial blood sample was collected after overnight fast and bed rest for at least 8 h in supine position for plasma renin activity and aldosterone concentration. Results: 8 (40%) patients in group A and 10 (50%) in group B responded to therapy. 22 (group A-12; group B-10) patients did not respond to treatment. There was a significant decrease in serum creatinine from baseline in both groups. Mean arterial pressure and urine output increased significantly in both groups at day 15. Plasma renin activity and aldosterone concentrations decreased significantly in both groups at day 15. Conclusion: In conclusion, norepinephrine and terlipressin had similar response rates or equally effective in cases of hepatorenal syndrome. But this study was based on a small population size. More studies are needed on a large scale to establish this as an alternate drug.
Abstract (English)
Aim: Assessment of norepinephrine and terlipressin in the management of Hepatorenal Syndrome. Materials and methods: A total of 40 patients with HRS type 1, presenting at the Department of Medicine, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India, were prospectively evaluated. Patients were randomized to either terlipressin or noradrenaline group i.e. half for terlipressin (group A) and half for noradrenaline (group B). Patients in either group received treatment with terlipressin or noradrenaline with 20 g albumin/day. Patients in group A received terlipressin as an intravenous bolus of 0.5 mg every 6 h. Patients in group B received a continuous infusion of noradrenaline at an initial dose of 0.5 mg/h, designed to achieve an increase in MAP of at least 10 mmHg or an increase in 4-h urine output of more than 200 ml. All patients were admitted for 15 days in hospital and followed-up to 30 days. Clinical and biochemical parameters were assessed at baseline, and day 15. An arterial blood sample was collected after overnight fast and bed rest for at least 8 h in supine position for plasma renin activity and aldosterone concentration. Results: 8 (40%) patients in group A and 10 (50%) in group B responded to therapy. 22 (group A-12; group B-10) patients did not respond to treatment. There was a significant decrease in serum creatinine from baseline in both groups. Mean arterial pressure and urine output increased significantly in both groups at day 15. Plasma renin activity and aldosterone concentrations decreased significantly in both groups at day 15. Conclusion: In conclusion, norepinephrine and terlipressin had similar response rates or equally effective in cases of hepatorenal syndrome. But this study was based on a small population size. More studies are needed on a large scale to establish this as an alternate drug.
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IJPCR,Vol14,Issue1,Article18.pdf
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Additional details
Dates
- Accepted
-
2021-12-22
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/14/IJPCR,Vol14,Issue1,Article18.pdf
- Development Status
- Active
References
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