Document Detail


A randomized controlled trial comparing octreotide and vasopressin in the control of acute esophageal variceal bleeding.
MedLine Citation:
PMID:  1487608     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This randomized controlled trial was conducted to compare the efficacy of intravenous infusion of octreotide (a synthetic long-acting somatostatin analogue) with vasopressin in 48 cirrhotic patients with endoscopically proven bleeding esophageal varices. Twenty-four patients received a continuous infusion of octreotide 25 micrograms/h for 24 h after an initial bolus of 100 micrograms and another 24 patients received a continuous infusion of vasopressin 0.4 U/min for 24 h. Bleeding was initially controlled after 6 h of drug infusion in 88% (21/24) and 54% (13/24) of the patients treated with octreotide and vasopressin respectively (p = 0.03). Complete control of bleeding after 24 h of drug infusion was achieved in 15 (63%) patients receiving octreotide and in 11 (46%) patients receiving vasopressin (p > 0.05). Side effects during drug infusion such as headache, chest pain and abdominal pain were significantly lower in the octreotide group (3/24) than in the vasopressin group (11/24). Serum gastrin and insulin levels fell significantly following octreotide infusion, but plasma glucose levels remained unchanged. Mortality related to bleeding esophageal varices was no different between the two groups. This report showed that octreotide infusion was more effective and had fewer side effects than vasopressin in initial controlling of acute esophageal variceal bleeding until an elective endoscopic sclerotherapy could be performed.
Authors:
S J Hwang; H C Lin; C F Chang; F Y Lee; C W Lu; H C Hsia; S S Wang; S D Lee; Y T Tsai; K J Lo
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hepatology     Volume:  16     ISSN:  0168-8278     ISO Abbreviation:  J. Hepatol.     Publication Date:  1992 Nov 
Date Detail:
Created Date:  1993-02-25     Completed Date:  1993-02-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  320-5     Citation Subset:  IM    
Affiliation:
Department of Medicine, Veterans General Hospital, Taipei, Taiwan, Republic of China.
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Glucose / metabolism
Esophageal and Gastric Varices / blood,  drug therapy*,  etiology
Female
Gastrins / blood
Gastrointestinal Hemorrhage / blood,  drug therapy*,  mortality
Humans
Hypertension, Portal / complications*
Injections, Intravenous
Insulin / blood
Liver Cirrhosis / complications*
Male
Middle Aged
Octreotide / adverse effects,  therapeutic use*
Vasopressins / adverse effects,  therapeutic use*
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Gastrins; 11000-17-2/Vasopressins; 11061-68-0/Insulin; 83150-76-9/Octreotide

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


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