Efficacy and safety of vasopressin and terlipressin in preterm neonates: a protocol for a systematic review

Background The use of vasoactive agents like arginine vasopressin (AVP) and terlipressin to treat hypotension or persistent pulmonary hypertension in critically ill preterm neonates is increasing. Therefore, a systematic review of the available data on dosing, efficacy and safety of AVP and terlipre...

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Main Authors: Samira Samiee-Zafarghandy, Abdul Razak, Katelyn Sushko, Abdulrahman Salim Alsaadi, Vivian Bui
Format: Article
Language:English
Published: BMJ Publishing Group 2021-10-01
Series:BMJ Paediatrics Open
Online Access:https://bmjpaedsopen.bmj.com/content/5/1/e001067.full
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author Samira Samiee-Zafarghandy
Abdul Razak
Katelyn Sushko
Abdulrahman Salim Alsaadi
Vivian Bui
author_facet Samira Samiee-Zafarghandy
Abdul Razak
Katelyn Sushko
Abdulrahman Salim Alsaadi
Vivian Bui
author_sort Samira Samiee-Zafarghandy
collection DOAJ
description Background The use of vasoactive agents like arginine vasopressin (AVP) and terlipressin to treat hypotension or persistent pulmonary hypertension in critically ill preterm neonates is increasing. Therefore, a systematic review of the available data on dosing, efficacy and safety of AVP and terlipressin in this patient population appears beneficial.Methods We will conduct a systematic review of the available evidence on the use of AVP and terlipressin for the treatment of hypotension or persistent pulmonary hypertension in preterm neonates. We will search Ovid MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science and Google Scholar from inception to March 2021. Two reviewers will independently screen titles and abstracts, review the full text of eligible studies, extract data, assess the risk of bias and judge the certainty of the evidence. Our primary outcome will be an (1) improvement of end-organ perfusion after initiation of AVP or terlipressin and (2) mortality prior to discharge. Our secondary outcomes will include (1) major neurosensory abnormality and (2) the occurrence of adverse events.Discussion The currently available evidence on the efficacy and safety of AVP and terlipressin in preterm neonates is limited. Yet, evidence on the pharmacology of these drugs and the pathophysiology of vasoplegic shock support the biological plausibility for their clinical effectiveness in this population. Therefore, we aim to address this gap concerning the use of vasopressin and terlipressin among critically ill preterm neonates.Trial registration This protocol has been submitted for registration to the international database of prospectively registered systematic reviews (PROSPERO, awaiting registration number).
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spelling doaj-art-52d06d13f1e148ecac984bd38ed212cd2025-08-20T02:10:53ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722021-10-015110.1136/bmjpo-2021-001067Efficacy and safety of vasopressin and terlipressin in preterm neonates: a protocol for a systematic reviewSamira Samiee-Zafarghandy0Abdul Razak1Katelyn Sushko2Abdulrahman Salim Alsaadi3Vivian Bui46Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada2 Pediatrics, McMaster University, Hamilton, Ontario, CanadaSchool of Nursing, McMaster University Faculty of Health Sciences, Hamilton, Ontario, CanadaDepartment of Pediatrics, McMaster University, Hamilton, Ontario, CanadaDepartment of Pharmacy, Hamilton, Ontario, CanadaBackground The use of vasoactive agents like arginine vasopressin (AVP) and terlipressin to treat hypotension or persistent pulmonary hypertension in critically ill preterm neonates is increasing. Therefore, a systematic review of the available data on dosing, efficacy and safety of AVP and terlipressin in this patient population appears beneficial.Methods We will conduct a systematic review of the available evidence on the use of AVP and terlipressin for the treatment of hypotension or persistent pulmonary hypertension in preterm neonates. We will search Ovid MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science and Google Scholar from inception to March 2021. Two reviewers will independently screen titles and abstracts, review the full text of eligible studies, extract data, assess the risk of bias and judge the certainty of the evidence. Our primary outcome will be an (1) improvement of end-organ perfusion after initiation of AVP or terlipressin and (2) mortality prior to discharge. Our secondary outcomes will include (1) major neurosensory abnormality and (2) the occurrence of adverse events.Discussion The currently available evidence on the efficacy and safety of AVP and terlipressin in preterm neonates is limited. Yet, evidence on the pharmacology of these drugs and the pathophysiology of vasoplegic shock support the biological plausibility for their clinical effectiveness in this population. Therefore, we aim to address this gap concerning the use of vasopressin and terlipressin among critically ill preterm neonates.Trial registration This protocol has been submitted for registration to the international database of prospectively registered systematic reviews (PROSPERO, awaiting registration number).https://bmjpaedsopen.bmj.com/content/5/1/e001067.full
spellingShingle Samira Samiee-Zafarghandy
Abdul Razak
Katelyn Sushko
Abdulrahman Salim Alsaadi
Vivian Bui
Efficacy and safety of vasopressin and terlipressin in preterm neonates: a protocol for a systematic review
BMJ Paediatrics Open
title Efficacy and safety of vasopressin and terlipressin in preterm neonates: a protocol for a systematic review
title_full Efficacy and safety of vasopressin and terlipressin in preterm neonates: a protocol for a systematic review
title_fullStr Efficacy and safety of vasopressin and terlipressin in preterm neonates: a protocol for a systematic review
title_full_unstemmed Efficacy and safety of vasopressin and terlipressin in preterm neonates: a protocol for a systematic review
title_short Efficacy and safety of vasopressin and terlipressin in preterm neonates: a protocol for a systematic review
title_sort efficacy and safety of vasopressin and terlipressin in preterm neonates a protocol for a systematic review
url https://bmjpaedsopen.bmj.com/content/5/1/e001067.full
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