Svoboda 2012.

Methods	Single‐centre randomized controlled trial, community hospital; Czech Republic
Participants	Adult patients with late advanced refractory septic shock, with blood pressure < 90 mm Hg systolic or < 70 mm Hg mean, who need norepinephrine > 0,6 µg/kg/min for longer than 24 hours after adequate volume resuscitation unless CVP > 12 mm Hg. Mean age = 73 years, 40% female. SOFA score 18, MODS 14 (N = 30)
Interventions	Terlipressin (4 mg/24 h) vs 'no terlipressin'
Outcomes	Mortality at day 3, day 7, day 14, day 28, day 90; haemodynamic response, norepinephrine requirement, changes in MODS and SOFA score, differences in laboratory variables and safety of treatment (serious adverse events) Arrhythmias CV events Limb/skin ischaemia Hepatosplanchnic ischaemia
Notes	Both groups received “conventional open label norepinephrine” Grant of IGA MZ CR NR 9284‐3
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer‐generated random treatment list
Allocation concealment (selection bias)	Low risk	Opaque sealed numbered envelopes
Incomplete outcome data (attrition bias) All outcomes	Low risk	Outcome data complete
Explicit in‐/exclusion criteria	Low risk	Described explicitly
ITT‐analysis	High risk	Excluded from analysis were participants who did not survive 3 hours after start of study drug infusion (also for mortality estimates)
Adequate patient description	Low risk	Adequately described
Identical care	Unclear risk	Open‐label intervention. Open‐label norepinephrine to maintain goal MAP. Target blood pressure determined by the doctor in charge for each individual participant, usually 70 ± 5 mm Hg
Outcome description	Low risk	Described
Physicians blinded	High risk	Not blinded
Outcome assessors blinded?	Unclear risk	Low risk for mortality, high risk for adverse outcomes