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Octreotide bolus injection and azygos blood flow in patients with cirrhosis: is the effect really predictable?

Published in Journal of Clinical Gastroenterology. 2010, vol. 44, no. 9, p. e206-209
Abstract BACKGROUND: Octreotide (OCT) improves the management of variceal bleeding, but the pattern of administration is not clearly defined. Available data show a transient decrease in portal pressure and azygos blood flow (AzBF) after OCT bolus injection with desensitization at readministration. AIM: To explore the sustained hemodynamic effects of OCT and changes associated with readministration at 60 minutes on AzBF in patients with portal hypertension. PATIENTS AND METHODS: AzBF was measured invasively (thermodilution technique) in 12 patients at baseline and at 10 minutes intervals after OCT 50-mug IV bolus for a total of 60 minutes. Readministration of OCT was followed by AzBF measurement for another 15 minutes. Patients [age 51.4 y (30 to 69)] had cirrhosis (alcoholic in 9 patients; Pugh's score 8.8+/-0.3), portal hypertension (HVPG 19+/-1 mm Hg), and elevated AzBF (658+/-138 mL/min). RESULTS: The bolus of OCT was followed at 10 minutes by a 34% decline in AzBF as compared with baseline value. This AzBF reduction was sustained over the 60-minute study period (-36%+/-1.4%) with the values that remained decreased as compared with baseline (P<0.01). Mean arterial pressure remained stable. At 60 minutes, the repeat OCT bolus induced a further significant (P<0.01) decline in AzBF, although the response was blunted (-18%+/-1.2%). CONCLUSION: The AzBF showed a sustained decrease of value after a bolus injection of 50-mug OCT. A further hemodynamic response is detectable at OCT readministration after 60 minutes. The pattern of hemodynamic response to OCT may not be uniform among cirrhotics.
Keywords AdultAgedAzygos Vein/drug effectsFemaleGastrointestinal Agents/administration & dosage/pharmacologyHemodynamicsHumansHypertension, Portal/ drug therapy/physiopathologyLiver Cirrhosis/ complications/drug therapyLiver Cirrhosis, Alcoholic/complicationsMaleMiddle AgedOctreotide/administration & dosage/ pharmacologyPortal Pressure/ drug effectsThermodilutionTime Factors
PMID: 19996986
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Research group Hépatologie chirurgicale (327)
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SPAHR, Laurent François Joséph et al. Octreotide bolus injection and azygos blood flow in patients with cirrhosis: is the effect really predictable?. In: Journal of Clinical Gastroenterology, 2010, vol. 44, n° 9, p. e206-209. doi: 10.1097/MCG.0b013e3181c4f111 https://archive-ouverte.unige.ch/unige:20710

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Deposited on : 2012-05-23

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