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
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
184
Terlipressin-2mg (low dose )
Noradrenaline at 7.5 mcg/min, maximum of 60mcg/min. stepped up every 15 min
Noradrenaline- 3.75 mcg/min to 30 mcg/min. stepped up every 15 min
Institute of Liver and Biliary Sciences
New Delhi, National Capital Territory of Delhi, India
Target MAP (Mean Arterial Pressure) >65 mm Hg at 6 hrs
Time frame: 6 hours
Maintenance of target MAP (Mean Arterial Pressure)
MAP is Mean Arterial pressure SVR is Sustained Virologic Response
Time frame: 2 days
Survival
Time frame: 28 days
Survival
Time frame: 48 hours
Microcirculation (lactate level, Lactate clearance, SCVO2, ABG-VBG Pco2 difference),
Time frame: 2 years
Tissue perfusion (lactate level, Lactate clearance, SCVO2, ABG-VBG Pco2 difference),
Time frame: 2 years
Effect on - AKI (Acute kidney Injury),
Time frame: 2 years
Effect on variceal bleed
Time frame: 2 years
Effect on rebound hypotension
Time frame: 2 years
Effect on organ failure
Time frame: 2 years
Length of ICU
Time frame: 2 years
Length of hospital stay.
Time frame: 2 years
Incidence of adverse events.
Time frame: 2 years
Predictors of adverse events.
Time frame: 2 years
SVR (Sustained Virologic Response) ≥600 at 48 hrs
Time frame: 2 days
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