Catecholamine-resistant shock is not uncommon in intensive care. Bolus dose terlipressin (a vasopressin analogue) has been used successfully in this setting allowing cessation of other vasopressor agents. The relative vasopressin deficiency in combination with the restoration of the vascular tone (by blocking adenosine triphosphate potassium-sensitive channels) by exogenous vasopressin may be the explanation of these beneficial effects. We describe a case report where the use of a continuous terlipressin infusion was associated with a dramatic improvement. To our knowledge there have been no previous reports of the use of terlipressin by continuous infusion for the treatment of catecholamine-resistant shock.
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