To Assess the Efficacy of Early Introduction of a Combination of Low Dose Vasopressin Analogue in Addition to Noradrenaline as a Vasopressor in Patients of Cirrhosis With Septic Shock

A Prospective Study to Assess the Efficacy of Early Introduction of a Combination of Low Dose Vasopressin Analogue in Addition to Noradrenaline as a Vasopressor in Patients of Cirrhosis With Septic Shock

The consecutive patients admitted to Intensive care unit of Hepatology department of ILBS and full filling all the eligibility criteria will be enrolled in 1:1 ration by the process of randomization.- The study is an open level study. The investigators will strictly follow the randomization table to give therapy as per the intervention arm.

• Intervention:-the therapeutic intervention is vasopressor i.e. noradrenaline alone and terlipressin along with noradrenaline to maintain the MAP >65mm Hg.

• Intervention arm

  • Arm (A) - Noradrenaline
  • Arm (B) - Noradrenaline + low dose terlipressin

Inclusion Criteria:

• 18-70 yr
• Cirrhosis with septic shock not responding to fluid resuscitation within 2 hrs.

Exclusion Criteria:

• ECG (ElectroCardiography)changes at presentation which exclude the use of vasopressin analouges
• Cardiac dysfunction ( valvular heart disease, coronary artery disease)
• Acute mesenteric ischemia (confirmed or suspected) or vasospastic diathesis (e.g. Reynaud's syndrome or related diseases).
• Pregnancy
• Acute GI bleed
• No Consent