Comparison of terlipressin and noradrenalin on cerebral perfusion, intracranial pressure and cerebral extracellular concentrations of lactate and pyruvate in patients with acute liver failure in need of inotropic support.

Comparison of terlipressin and noradrenalin on cerebral perfusion, intracranial pressure and cerebral extracellular concentrations of lactate and pyruvate in patients with acute liver failure in need of inotropic support. Research Abstract Details 

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Comparison of terlipressin and noradrenalin on cerebral perfusion, intracranial pressure and cerebral extracellular concentrations of lactate and pyruvate in patients with acute liver failure in need of inotropic support. Abstract Text:

Martin Eefsen,Thomas Dethloff,Hans-Jorgen Frederiksen,John Hauerberg,Bent Adel Hansen,Fin Stolze Larsen,

BACKGROUND/AIMS: Volume expansion and inotropic support with catecholamines are sometimes insufficient to ensure adequate blood pressure and cerebral perfusion in acute liver failure (ALF). The aim of this study was to determine if terlipressin increases cerebral perfusion, cerebral concentration of lactate and intracranial pressure (ICP), and to compare the effect with that of noradrenalin (NA). METHODS: Ten patients (median age 42.5 yr; range 15-66; 5 women) who needed inotropic support and had an ICP and a cerebral microdialysis catheter placed had concomitant recording of cerebral perfusion pressure (CPP), cerebral perfusion (using transcranial Doppler sonography (V(mean))) and ICP. Also cerebral extracellular concentration of lactate ([lactate]ec) and pyruvate ([pyruvate]ec) was collected before and after an increase in the NA infusion rate and/or i.v.-injection of 1mg terlipressin. RESULTS: Both NA and terlipressin increased CPP and V(mean) (p<0.01). Also ICP increased during NA infusion (p<0.01) but not after terlipressin. The cerebral [lactate]ec decreased after terlipressin injection from 2.34 (1.52-8.38) to 1.99 (0.03-4.83)mmol/l (p=0.027) but not during NA infusion (2.83 (1.53-7.11)mmol/l). The [lactate]ec to [pyruvate]ec ratio remained unchanged in both the NA group (20.7 (13.2-40.0)) and terlipressin group (22.2 (10.5-30.0)). CONCLUSIONS: This study shows that terlipressin increases CPP and cerebral perfusion with little influence upon ICP and cerebral [lactate]ec in ALF patients. These findings indicate that terlipressin may be valuable, as an additive treatment to NA infusion to secure brain viability.

Comparison of terlipressin and noradrenalin on cerebral perfusion, intracranial pressure and cerebral extracellular concentrations of lactate and pyruvate in patients with acute liver failure in need of inotropic support. Publishing Authors By Initials

M Eefsen,T Dethloff,HJ Frederiksen,J Hauerberg,BA Hansen,FS Larsen,

For similar chemical actions and uses: pharmacologic actions: therapeutic uses: cardiovascular agents: vasoconstrictor agents research abstracts see: chemical actions and uses: pharmacologic actions: therapeutic uses: cardiovascular agents: vasoconstrictor agents research

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Comparison of terlipressin and noradrenalin on cerebral perfusion, intracranial pressure and cerebral extracellular concentrations of lactate and pyruvate in patients with acute liver failure in need of inotropic support. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Journal of hepatology

VOLUME: 47

Page Numbers: 381-6

Journal Abbreviation: J. Hepatol.

ISSN: 0168-8278

DAY: 30

MONTH: 05

YEAR: 2007

Comparison of terlipressin and noradrenalin on cerebral perfusion, intracranial pressure and cerebral extracellular concentrations of lactate and pyruvate in patients with acute liver failure in need of inotropic support. Information

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LANGUAGE: eng

NlmUniqueID: 8503886

Comparison of terlipressin and noradrenalin on cerebral perfusion, intracranial pressure and cerebral extracellular concentrations of lactate and pyruvate in patients with acute liver failure in need of inotropic support. Keywords Mesh Terms:

KEYWORDS: Vasoconstrictor Agents

MESH TERMS: therapeutic use

Chemical & Substance for Abstract: Comparison of terlipressin and noradrenalin on cerebral perfusion, intracranial pressure and cerebral extracellular concentrations of lactate and pyruvate in patients with acute liver failure in need of inotropic support. Information

Substance Name: Norepinephrine

Registry Number: 51-41-2

Grant and Affiliation Information for Comparison of terlipressin and noradrenalin on cerebral perfusion, intracranial pressure and cerebral extracellular concentrations of lactate and pyruvate in patients with acute liver failure in need of inotropic support.

AFFILIATION: Department of Hepatology, A-2121, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark.

Country: England

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MEDLINETA: J Hepatol

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