title: High-dose vasopressin for acute variceal hemorrhage. Clinical advantages without adverse effects.
abstract: Based on laboratory and clinical data from our institution, 113 patients with cirrhosis, portal hypertension, and acute hemorrhage from esophageal varices were treated with high-dose vasopressin arginine (1 to 1.5 U/min) to control the acute bleeding and reduce blood loss during portosystemic shunt operations. Compared with patients receiving a lower dose of vasopressin infusion, these patients had a reduction in both postoperative mortality (21% vs 6%) and the proportion of patients requiring emergency operation (40% vs 18%). A decrease in operative blood loss (1340 vs 793 mL) was also seen. Adverse effects of vasopressin were increased by high-dose infusion, but no significant morbidity occurred. These results suggest that high-dose vasopressin infusion can reduce the mortality of acute variceal hemorrhage and porto-systemic shunting primarily by allowing patients to improve hepatic function prior to an elective operation and by decreasing intraoperative blood loss.
authors.affiliation: Department of Surgery, University of Texas Health Science Center, San Antonio.
authors.forename: K R
authors.initials: KR
authors.lastname: Sirinek
authors.forename: B A
authors.initials: BA
authors.lastname: Levine
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000150:complications* / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical; D014667:Vasopressins / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D014667:Vasopressins