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28 July 2003

Somatostatin infusion and hemodynamic changes in patients with non-variceal upper gastrointestinal bleeding: a pilot study

Murat Saruc, Mine Can, Nurten Kucukmetin, Isil Tuzcuoglu, Serdar Tarhan, Cihan Goktan, Hakan Yuceyar

Med Sci Monit 2003; 9(7): PI84-87 :: ID: 13067

Abstract

Background:Intravenous somatostatin decreases acid secretion, splanchnic blood flow, and portal pressure, but the evidence for its efficacy in the treatment of non-variceal upper gastrointestinal bleeding has been mixed. We aimed to evaluate the vasoactive effect and possible mechanisms of somatostatin infusion in the cessation of non-variceal upper gastrointestinal bleeding.Material/Methods:Patients with non-variceal upper gastrointestinal bleeding without portal hypertension were enrolled in the study. They were given somatostatin infusion in a dose of 250 Kgr/hour for 72 hours. Superior mesenteric arterial average flow velocity (SMA-V), SMA pulsatility index (SMA-PI), portal venous volume flow (PV-F), and renal artery resistance index (RA-RI) were measured two times for each patient by Doppler ultrasound; oncee on the first day of infusion therapy and again 6 hours or more after stopping the infusion.Results:21 patients (12 male, mean age 44.1I9.9) with bleeding peptic ulcer were enrolled. During somatostatin infusion, PV-F was 33.7I12.7 cm3/sec. After stopping infusion, it increased to 56.3I16.0 cm3/sec (p=0.001). SMA-V was 39.7I13.1 cm/sec and 64.4I15.1 cm/sec during somatostatin infusion and after cessation of somatostatin respectively (p=0.01). SMA-PI was 2.0I0.8 during somatostatin infusion but 2.8I0.8 without somatostatin infusion (p=0.02). However, RA-RI showed no difference between states with or without somatostatin infusion (p>0.05).Conclusions:Somatostatin infusion causes a decrease in arterial blood flow to the stomach and duodenum in patients with non-variceal upper gastrointestinal bleeding without portal hypertension. Somatostatin therapy also decreases portal blood flow while not altering renal blood.

Keywords: Duodenum - blood supply, Duodenum - drug effects, Esophageal and Gastric Varices, Gastrointestinal Hemorrhage - drug therapy, Hemodynamic Processes - drug effects, Hormones - pharmacology, Hormones - therapeutic use, Pilot Projects, Regional Blood Flow, Somatostatin - pharmacology, Somatostatin - therapeutic use, Statistics, Stomach - blood supply, Stomach - drug effects

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750