TY - JOUR
T1 - Vasopressin in hemorrhagic shock: a systematic review and meta-analysis of randomized animal trials
AU - Cossu, Andrea Pasquale
AU - Mura, Paolo
AU - De Giudici, Lorenzo Matteo
AU - Puddu, Daniela
AU - Pasin, Laura
AU - Evangelista, Maurizio
AU - Xanthos, Theodoros
AU - Musu, Mario
AU - Finco, Gabriele
PY - 2014
Y1 - 2014
N2 - Objective. The latest European guidelines for the management of hemorrhagic shock suggest the use of vasopressors (norepinephrine) in order to restore an adequate mean arterial pressure when fluid resuscitation therapy fails to restore blood pressure. The administration of arginine vasopressin (AVP), or its analogue terlipressin, has been proposed as an alternative treatment in the early stages of hypovolemic shock. Design. A meta-analysis of randomized controlled animal trials. Participants. A total of 433 animals from 15 studies were included. Interventions. The ability of AVP and terlipressin to reduce mortality when compared with fluid resuscitation therapy, other vasopressors (norepinephrine or epinephrine), or placebo was investigated. Measurements and Main Results. Pooled estimates showed that AVP and terlipressin consistently and significantly improve survival in hemorrhagic shock (mortality: 26/174 (15%) in the AVP group versus 164/259 (63%) in the control arms; ; 95% CI 0.05 to 0.15; for effect < 0.001; for heterogeneity = 0.30; ). Conclusions. Results suggest that AVP and terlipressin improve survival in the early phases of animal models of hemorrhagic shock. Vasopressin seems to be more effective than all other treatments, including other vasopressor drugs. These results need to be confirmed by human clinical trials.
AB - Objective. The latest European guidelines for the management of hemorrhagic shock suggest the use of vasopressors (norepinephrine) in order to restore an adequate mean arterial pressure when fluid resuscitation therapy fails to restore blood pressure. The administration of arginine vasopressin (AVP), or its analogue terlipressin, has been proposed as an alternative treatment in the early stages of hypovolemic shock. Design. A meta-analysis of randomized controlled animal trials. Participants. A total of 433 animals from 15 studies were included. Interventions. The ability of AVP and terlipressin to reduce mortality when compared with fluid resuscitation therapy, other vasopressors (norepinephrine or epinephrine), or placebo was investigated. Measurements and Main Results. Pooled estimates showed that AVP and terlipressin consistently and significantly improve survival in hemorrhagic shock (mortality: 26/174 (15%) in the AVP group versus 164/259 (63%) in the control arms; ; 95% CI 0.05 to 0.15; for effect < 0.001; for heterogeneity = 0.30; ). Conclusions. Results suggest that AVP and terlipressin improve survival in the early phases of animal models of hemorrhagic shock. Vasopressin seems to be more effective than all other treatments, including other vasopressor drugs. These results need to be confirmed by human clinical trials.
KW - hemorragic shock
KW - meta-analysis
KW - randomized animal trials
KW - vasopressin
KW - hemorragic shock
KW - meta-analysis
KW - randomized animal trials
KW - vasopressin
UR - http://hdl.handle.net/10807/64275
UR - http://www.hindawi.com/journals/bmri/2014/421291/
U2 - http://dx.doi.org/10.1155/2014/421291
DO - http://dx.doi.org/10.1155/2014/421291
M3 - Article
VL - Volume 2014 (2014), Article ID 421291, 9 pages
SP - N/A-N/A
JO - BioMed Research International
JF - BioMed Research International
SN - 2314-6133
ER -