Acute Hemodynamic Effects of Octreotide and Terlipressin in Patients with Cirrhosis: A Randomized Comparison

• DOI: 10.1111/j.1572-0241.2005.41381.x
• Publication Date: 2005-03-02T17:59:25Z
• Authors: Soon Koo Baik; Phil Ho Jeong; Sang Won Ji; Byung Su Yoo; Hyun Soo Kim; Dong Ki Lee; Sang Ok Kwon; Young Ju Kim; Joong Wha Park; Sei Jin Chang; Samuel S Lee
• Keywords: Terlipressin; Bolus (digestion); Mean arterial pressure

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) pressure. Little is known about immediate-early hemodynamic effects of these drugs. AIM To compare octreotide patients with cirrhosis. PATIENTS Forty-two cirrhotic a history were randomized receive either 100 μg intravenous bolus followed continuous infusion at 250 μg/h (n = 21), or 2 mg 21). METHODS Mean pressure (MAP), heart rate (HR), hepatic gradient (HVPG), PVF, assessed duplex Doppler ultrasonography, measured before 1, 5, 10, 15, 20, 25 min after start drug administration. RESULTS markedly decreased HVPG (−44.5 ± 17.8%) PVF (−30.6 13.6%) compared baseline 1 (p < 0.05). Thereafter, both variables rapidly returned toward baseline, 5 min, no significant differences (−7.1 28.9%) (10.2 26.2%) noted. A similar transient effect on MAP HR was observed. Terlipressin significantly (−18.3 11.9%) (−32.6 10.5%) 0.05) sustained all time points. The also sustained. CONCLUSIONS only transiently reduced flow, whereas These results suggest that may have more varices.