Long-term haemodynamic effects of octreotide on postprandial splanchnic hyperemia in humans: a placebo-controlled echo-doppler study.
BACKGROUND
Octreotide is a potent splanchnic hypotensive somatostatin analogue effective in the treatment of acute variceal bleeding.


OBJECTIVE
To study the effects of octreotide on basal and postprandial splanchnic and systemic haemodynamics, and hormonal changes in humans.


METHODS
Twenty-four healthy volunteers were randomized to receive a liquid meal and either octreotide (OCT, 100 microg bolus) or placebo repeatedly every 4 h for 48 h. Splanchnic (Doppler ultrasound) and systemic haemodynamics (non-invasive cardiac monitoring) were assessed for 2 h on four consecutive days: one control day and after doses 1 (0 h), 7 (24 h) and 13 (48 h).


RESULTS
The maximum postprandial increases in mean blood velocity of the superior mesenteric artery (SMA-Vmean +72%), portal (PBF +52%) and total hepatic blood flow (HBF +50%) observed in the placebo group, were abolished after the first dose of octreotide (SMA-Vmean -23%, P<0.01; PBF -22%, P<0.01; HBF -21%, P<0.01). Postprandial hyperemia was restored at the end of the 48-h study period, but baseline SMA-Vmean (placebo 40+/-12, OCT 29+/-11 cm/s, P<0.05) and PBF (placebo 1200+/-971, OCT 743+/-449 mL/min, P<0.05) remained significantly lower in the octreotide group. The postprandial decrease of systemic vascular resistance and increase of cardiac index were prevented by octreotide for 48 h.


CONCLUSIONS
Repeated 4-hourly bolus injections of octreotide reduce splanchnic blood flow for at least 48 h, but the prevention of food-induced splanchnic hyperemia is short-lasting.
Ludwig
D
D
Department of Internal Medicine I, Division of Gastroenterology, University of Lübeck, Lübeck, Germany. ludwigd@medinf.mu-luebeck.de
Terai
S
S
Brüning
A
A
Stange
E F
EF
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D005765:Gastrointestinal Agents / Q000494:pharmacology*; D006439:Hemodynamics / Q000187:drug effects*; D006499:Hepatic Artery / Q000187:drug effects; D006728:Hormones / Q000097:blood; D006801:Humans; D006940:Hyperemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D017538:Mesenteric Artery, Superior / Q000187:drug effects; D015282:Octreotide / Q000494:pharmacology*; D011169:Portal Vein / Q000187:drug effects; D019518:Postprandial Period / Q000502:physiology*; D013152:Splanchnic Circulation / Q000187:drug effects*; D014463:Ultrasonography
D001786:Blood Glucose; D005765:Gastrointestinal Agents; D006728:Hormones; D015282:Octreotide