Document Detail


Octreotide bolus injection and azygos blood flow in patients with cirrhosis: is the effect really predictable?
MedLine Citation:
PMID:  19996986     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Octreotide (OCT) improves the management of variceal bleeding, but the pattern of administration is not clearly defined. Available data show a transient decrease in portal pressure and azygos blood flow (AzBF) after OCT bolus injection with desensitization at readministration.
AIM: To explore the sustained hemodynamic effects of OCT and changes associated with readministration at 60 minutes on AzBF in patients with portal hypertension.
PATIENTS AND METHODS: AzBF was measured invasively (thermodilution technique) in 12 patients at baseline and at 10 minutes intervals after OCT 50-μg IV bolus for a total of 60 minutes. Readministration of OCT was followed by AzBF measurement for another 15 minutes. Patients [age 51.4 y (30 to 69)] had cirrhosis (alcoholic in 9 patients; Pugh's score 8.8±0.3), portal hypertension (HVPG 19±1 mm Hg), and elevated AzBF (658±138 mL/min).
RESULTS: The bolus of OCT was followed at 10 minutes by a 34% decline in AzBF as compared with baseline value. This AzBF reduction was sustained over the 60-minute study period (-36%±1.4%) with the values that remained decreased as compared with baseline (P<0.01). Mean arterial pressure remained stable. At 60 minutes, the repeat OCT bolus induced a further significant (P<0.01) decline in AzBF, although the response was blunted (-18%±1.2%).
CONCLUSION: The AzBF showed a sustained decrease of value after a bolus injection of 50-μg OCT. A further hemodynamic response is detectable at OCT readministration after 60 minutes. The pattern of hemodynamic response to OCT may not be uniform among cirrhotics.
Authors:
Laurent Spahr; Emiliano Giostra; Gilles Mentha; Antoine Hadengue
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical gastroenterology     Volume:  44     ISSN:  1539-2031     ISO Abbreviation:  J. Clin. Gastroenterol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-17     Completed Date:  2011-01-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7910017     Medline TA:  J Clin Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e206-9     Citation Subset:  IM    
Affiliation:
Gastroenterology and Hepatology Unit, University Hospitals, Geneva, Switzerland. Laurent.Spahr@hcuge.ch
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Azygos Vein / drug effects
Female
Gastrointestinal Agents / administration & dosage,  pharmacology
Hemodynamics
Humans
Hypertension, Portal / drug therapy*,  physiopathology
Liver Cirrhosis / complications*,  drug therapy
Liver Cirrhosis, Alcoholic / complications
Male
Middle Aged
Octreotide / administration & dosage,  pharmacology*
Portal Pressure / drug effects*
Thermodilution
Time Factors
Chemical
Reg. No./Substance:
0/Gastrointestinal Agents; 83150-76-9/Octreotide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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