TY - JOUR
T1 - Acute hemodynamic effects of octreotide and terlipressin in patients with cirrhosis
T2 - A randomized comparison
AU - Baik, Soon Koo
AU - Jeong, Phil Ho
AU - Ji, Sang Won
AU - Yoo, Byung Su
AU - Kim, Hyun Soo
AU - Lee, Dong Ki
AU - Kwon, Sang Ok
AU - Kim, Young Ju
AU - Park, Joong Wha
AU - Chang, Sei Jin
AU - Lee, Samuel S.
PY - 2005/3
Y1 - 2005/3
N2 - BACKGROUND: Octreotide and terlipressin are widely used in acute variceal hemorrhage to reduce the bleeding rate. They purportedly act by mesenteric arterial vasoconstriction, thus reducing portal venous flow (PVF) and portal pressure. Little is known about the immediate-early hemodynamic effects of these drugs. AIM: To compare the acute hemodynamic effects of octreotide and terlipressin in patients with cirrhosis. PATIENTS: Forty-two cirrhotic patients with a history of variceal bleeding were randomized to receive either octreotide 100 μg intravenous bolus followed by a continuous infusion at 250 μg/h (n = 21), or terlipressin 2 mg intravenous bolus (n = 21). METHODS: Mean arterial pressure (MAP), heart rate (HR), hepatic venous pressure gradient (HVPG), and PVF, assessed by duplex Doppler ultrasonography, were measured before and at 1, 5, 10, 15, 20, and 25 min after the start of drug administration. RESULTS: Octreotide markedly decreased HVPG (-44.5 ± 17.8%) and PVF (-30.6 ± 13.6%) compared to the baseline at 1 min (p < 0.05). Thereafter, both variables rapidly returned toward the baseline, and by 5 min, no significant differences in HVPG (-7.1 ± 28.9%) and PVF (10.2 ± 26.2%) were noted. A similar transient effect on MAP and HR was observed. Terlipressin significantly decreased HVPG (-18.3 ± 11.9%) and PVF (-32.6 ± 10.5%) at 1 min (p < 0.05) and sustained these effects at all time points. The effects on arterial pressure and HR were also sustained. CONCLUSIONS: Octreotide only transiently reduced portal pressure and flow, whereas the effects of terlipressin were sustained. These results suggest that terlipressin may have more sustained hemodynamic effects in patients with bleeding varices.
AB - BACKGROUND: Octreotide and terlipressin are widely used in acute variceal hemorrhage to reduce the bleeding rate. They purportedly act by mesenteric arterial vasoconstriction, thus reducing portal venous flow (PVF) and portal pressure. Little is known about the immediate-early hemodynamic effects of these drugs. AIM: To compare the acute hemodynamic effects of octreotide and terlipressin in patients with cirrhosis. PATIENTS: Forty-two cirrhotic patients with a history of variceal bleeding were randomized to receive either octreotide 100 μg intravenous bolus followed by a continuous infusion at 250 μg/h (n = 21), or terlipressin 2 mg intravenous bolus (n = 21). METHODS: Mean arterial pressure (MAP), heart rate (HR), hepatic venous pressure gradient (HVPG), and PVF, assessed by duplex Doppler ultrasonography, were measured before and at 1, 5, 10, 15, 20, and 25 min after the start of drug administration. RESULTS: Octreotide markedly decreased HVPG (-44.5 ± 17.8%) and PVF (-30.6 ± 13.6%) compared to the baseline at 1 min (p < 0.05). Thereafter, both variables rapidly returned toward the baseline, and by 5 min, no significant differences in HVPG (-7.1 ± 28.9%) and PVF (10.2 ± 26.2%) were noted. A similar transient effect on MAP and HR was observed. Terlipressin significantly decreased HVPG (-18.3 ± 11.9%) and PVF (-32.6 ± 10.5%) at 1 min (p < 0.05) and sustained these effects at all time points. The effects on arterial pressure and HR were also sustained. CONCLUSIONS: Octreotide only transiently reduced portal pressure and flow, whereas the effects of terlipressin were sustained. These results suggest that terlipressin may have more sustained hemodynamic effects in patients with bleeding varices.
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U2 - 10.1111/j.1572-0241.2005.41381.x
DO - 10.1111/j.1572-0241.2005.41381.x
M3 - Article
C2 - 15743362
AN - SCOPUS:20144389166
SN - 0002-9270
VL - 100
SP - 631
EP - 635
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
IS - 3
ER -