Effects of terlipressin infusion during hepatobiliary surgery on systemic and splanchnic haemodynamics, renal function and blood loss: a double-blind, randomized clinical trial
Abstract Background Terlipressin, in general, is a vasopressor which acts via V1 receptors. Its infusion elevates mean blood pressure and can reduce bleeding which has a splanchnic origin. The primary outcome was to assess the impact of intraoperative terlipressin infusion on portal venous pressure...
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| Format: | Article |
| Language: | English |
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BMC
2019-06-01
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| Series: | BMC Anesthesiology |
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| Online Access: | http://link.springer.com/article/10.1186/s12871-019-0779-6 |
| _version_ | 1818420247659544576 |
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| author | Magdy Mohammed Mahdy Mostafa Samy Abbas Emad Zarief Kamel Mohamed Fathy Mostafa Ragaa Herdan Shimaa Abbas Hassan Ramy Hassan Ahmed M. Taha Tameem M. Ibraheem Bashir A. Fadel Mohammed Geddawy Jehan Ahmed Sayed Osama Ali Ibraheim |
| author_facet | Magdy Mohammed Mahdy Mostafa Samy Abbas Emad Zarief Kamel Mohamed Fathy Mostafa Ragaa Herdan Shimaa Abbas Hassan Ramy Hassan Ahmed M. Taha Tameem M. Ibraheem Bashir A. Fadel Mohammed Geddawy Jehan Ahmed Sayed Osama Ali Ibraheim |
| author_sort | Magdy Mohammed Mahdy |
| collection | DOAJ |
| description | Abstract Background Terlipressin, in general, is a vasopressor which acts via V1 receptors. Its infusion elevates mean blood pressure and can reduce bleeding which has a splanchnic origin. The primary outcome was to assess the impact of intraoperative terlipressin infusion on portal venous pressure during hepatobiliary surgery; the 2ry outcomes included effects upon systemic hemodynamics, estimated blood loss, and postoperative renal functions. Methods This prospective randomized study involved 50 patients undergoing hepatobiliary surgery who were randomly and equally allocated into terlipressin group, or a control group. The terlipressin group received an initial bolus dose of (1 mg over 30 min) followed by a continuous infusion of 2 μg/kg/h throughout the procedure and gradually weaned over the first four postoperative hours, whereas the control group received the same volumes of normal saline. The portal venous pressure changes were measured directly through a portal vein angiocatheter. Results Portal pressure was significantly reduced over time in the terlipressin group only (from 17.88 ± 7.32 to 15.96 ± 6.55 mmHg, p < .001). Mean arterial blood pressure was significantly higher in the terlipressin group. Estimated blood loss was significantly higher in the control group than the terlipressin group (1065.7 ± 202 versus 842 ± 145.5 ml; p = 0.004), and the units of packed RBCs transfused were significantly higher in the control group ((0–2) versus (0–4) p = 0.003). There was no significant difference between groups as regards the incidence of acute kidney injury. Conclusion Intraoperative infusion of terlipressin during hepatobiliary surgery was shown to improve intraoperative portal hemodynamics with subsequent reduction in blood loss. Trial registration Clinical trial number and registry URL: Trial registration number: NCT02718599. Name of registry: ClinicalTrials.gov. URL of registry: https://clinicaltrials.gov/ct2/show/NCT02718599. Date of registration: March 2016. Date of enrolment of the first participant to the trial: April 2016. |
| first_indexed | 2024-12-14T12:51:26Z |
| format | Article |
| id | doaj.art-bced4276669b431195ab0170ca150a83 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-14T12:51:26Z |
| publishDate | 2019-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-bced4276669b431195ab0170ca150a832022-12-21T23:00:40ZengBMCBMC Anesthesiology1471-22532019-06-011911910.1186/s12871-019-0779-6Effects of terlipressin infusion during hepatobiliary surgery on systemic and splanchnic haemodynamics, renal function and blood loss: a double-blind, randomized clinical trialMagdy Mohammed Mahdy0Mostafa Samy Abbas1Emad Zarief Kamel2Mohamed Fathy Mostafa3Ragaa Herdan4Shimaa Abbas Hassan5Ramy Hassan6Ahmed M. Taha7Tameem M. Ibraheem8Bashir A. Fadel9Mohammed Geddawy10Jehan Ahmed Sayed11Osama Ali Ibraheim12Anesthesia and intensive care medicine, Faculty of Medicine, Assiut UniversityAnesthesia and intensive care medicine, Faculty of Medicine, Assiut UniversityAnesthesia and intensive care medicine, Faculty of Medicine, Assiut UniversityAnesthesia and intensive care medicine, Faculty of Medicine, Assiut UniversityAnesthesia and intensive care medicine, Faculty of Medicine, Assiut UniversityAnesthesia and intensive care medicine, Faculty of Medicine, Assiut UniversityHepatobiliary surgery, Faculty of Medicine, Assiut UniversityHepatobiliary surgery, Faculty of Medicine, Assiut UniversityHepatobiliary surgery, Faculty of Medicine, Assiut UniversityHepatobiliary surgery, Faculty of Medicine, Assiut UniversityKing Faisal Specialist Hospital & Research CenterAnesthesia and intensive care medicine, Faculty of Medicine, Assiut UniversityAnesthesia and intensive care medicine, Faculty of Medicine, Assiut UniversityAbstract Background Terlipressin, in general, is a vasopressor which acts via V1 receptors. Its infusion elevates mean blood pressure and can reduce bleeding which has a splanchnic origin. The primary outcome was to assess the impact of intraoperative terlipressin infusion on portal venous pressure during hepatobiliary surgery; the 2ry outcomes included effects upon systemic hemodynamics, estimated blood loss, and postoperative renal functions. Methods This prospective randomized study involved 50 patients undergoing hepatobiliary surgery who were randomly and equally allocated into terlipressin group, or a control group. The terlipressin group received an initial bolus dose of (1 mg over 30 min) followed by a continuous infusion of 2 μg/kg/h throughout the procedure and gradually weaned over the first four postoperative hours, whereas the control group received the same volumes of normal saline. The portal venous pressure changes were measured directly through a portal vein angiocatheter. Results Portal pressure was significantly reduced over time in the terlipressin group only (from 17.88 ± 7.32 to 15.96 ± 6.55 mmHg, p < .001). Mean arterial blood pressure was significantly higher in the terlipressin group. Estimated blood loss was significantly higher in the control group than the terlipressin group (1065.7 ± 202 versus 842 ± 145.5 ml; p = 0.004), and the units of packed RBCs transfused were significantly higher in the control group ((0–2) versus (0–4) p = 0.003). There was no significant difference between groups as regards the incidence of acute kidney injury. Conclusion Intraoperative infusion of terlipressin during hepatobiliary surgery was shown to improve intraoperative portal hemodynamics with subsequent reduction in blood loss. Trial registration Clinical trial number and registry URL: Trial registration number: NCT02718599. Name of registry: ClinicalTrials.gov. URL of registry: https://clinicaltrials.gov/ct2/show/NCT02718599. Date of registration: March 2016. Date of enrolment of the first participant to the trial: April 2016.http://link.springer.com/article/10.1186/s12871-019-0779-6TerlipressinPortal pressureHemodynamicsBlood loss |
| spellingShingle | Magdy Mohammed Mahdy Mostafa Samy Abbas Emad Zarief Kamel Mohamed Fathy Mostafa Ragaa Herdan Shimaa Abbas Hassan Ramy Hassan Ahmed M. Taha Tameem M. Ibraheem Bashir A. Fadel Mohammed Geddawy Jehan Ahmed Sayed Osama Ali Ibraheim Effects of terlipressin infusion during hepatobiliary surgery on systemic and splanchnic haemodynamics, renal function and blood loss: a double-blind, randomized clinical trial BMC Anesthesiology Terlipressin Portal pressure Hemodynamics Blood loss |
| title | Effects of terlipressin infusion during hepatobiliary surgery on systemic and splanchnic haemodynamics, renal function and blood loss: a double-blind, randomized clinical trial |
| title_full | Effects of terlipressin infusion during hepatobiliary surgery on systemic and splanchnic haemodynamics, renal function and blood loss: a double-blind, randomized clinical trial |
| title_fullStr | Effects of terlipressin infusion during hepatobiliary surgery on systemic and splanchnic haemodynamics, renal function and blood loss: a double-blind, randomized clinical trial |
| title_full_unstemmed | Effects of terlipressin infusion during hepatobiliary surgery on systemic and splanchnic haemodynamics, renal function and blood loss: a double-blind, randomized clinical trial |
| title_short | Effects of terlipressin infusion during hepatobiliary surgery on systemic and splanchnic haemodynamics, renal function and blood loss: a double-blind, randomized clinical trial |
| title_sort | effects of terlipressin infusion during hepatobiliary surgery on systemic and splanchnic haemodynamics renal function and blood loss a double blind randomized clinical trial |
| topic | Terlipressin Portal pressure Hemodynamics Blood loss |
| url | http://link.springer.com/article/10.1186/s12871-019-0779-6 |
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