Somatostatin infusion and hemodynamic changes in patients with non-variceal upper gastrointestinal bleeding: A pilot study
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Date
2003
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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 μgr/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 44.1±9.9) with bleeding peptic ulcer were enrolled. During somatostatin infusion, PV-F was 33.7±19.7 cm3/sec. After stopping infusion, it increased to 56.3±16.0 cm3/sec (p=0.001). SMA-V was 39.7±13.1 cm/ sec and 64.4±15.1 cm/sec during somatostatin infusion and after cessation of somatostatin respectively (p=0.01). SMA-PI was 2.0±0.8 during somatostatin infusion but 2.8±0.8 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.
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Adult , Duodenum , Esophageal and Gastric Varices , Gastrointestinal Hemorrhage , Hemodynamic Processes , Hormones , Humans , Male , Middle Aged , Pilot Projects , Regional Blood Flow , Somatostatin , Statistics , Stomach , Treatment Outcome , somatostatin , adult , artery blood flow , artery resistance , article , blood flow velocity , clinical article , controlled study , Doppler echography , drug effect , drug efficacy , drug infusion , female , hemodynamics , human , intestine blood flow , kidney artery , male , peptic ulcer bleeding , pilot study , portal vein blood flow , pulse wave , stomach blood flow , superior mesenteric artery , upper gastrointestinal bleeding