title: Somatostatin infusion and hemodynamic changes in patients with non-variceal upper gastrointestinal bleeding: a pilot study.
abstract: BACKGROUND
  Intravenous somatostatin decreases acid secretion, splanchnic blood flow, and portal pressure, but the evidence for its efficacy in the treatment of non-variceal upper gastrointestinal bleeding has been mixed. We aimed to evaluate the vasoactive effect and possible mechanisms of somatostatin infusion in the cessation of non-variceal upper gastrointestinal bleeding.
  
  
  METHODS
  Patients with non-variceal upper gastrointestinal bleeding without portal hypertension were enrolled in the study. They were given somatostatin infusion in a dose of 250 microgr/hour for 72 hours. Superior mesenteric arterial average flow velocity (SMA-V), SMA pulsatility index (SMA-PI), portal venous volume flow (PV-F), and renal artery resistance index (RA-RI) were measured two times for each patient by Doppler ultrasound; once on the first day of infusion therapy and again 6 hours or more after stopping the infusion.
  
  
  RESULTS
  21 patients (12 male, mean age 44.1 +/- 9.9) with bleeding peptic ulcer were enrolled. During somatostatin infusion, PV-F was 33.7 +/- 12.7 cm3/sec. After stopping infusion, it increased to 56.3 +/- 16.0 cm3/sec (p=0.001). SMA-V was 39.7 +/- 13.1 cm/sec and 64.4 +/- 15.1 cm/sec during somatostatin infusion and after cessation of somatostatin respectively (p=0.01). SMA-PI was 2.0 +/- 0.8 during somatostatin infusion but 2.8 +/- 0.8 without somatostatin infusion (p=0.02). However, RA-RI showed no difference between states with or without somatostatin infusion (p>0.05).
  
  
  CONCLUSIONS
  Somatostatin infusion causes a decrease in arterial blood flow to the stomach and duodenum in patients with non-variceal upper gastrointestinal bleeding without portal hypertension. Somatostatin therapy also decreases portal blood flow while not altering renal blood.
authors.affiliation: University of Nebraska Medical Center, Eppley Institute for Research in Cancer and Allied Diseases, Omaha, USA. msaruc@hotmail.com
authors.forename: Murat
authors.initials: M
authors.lastname: Saruç
authors.forename: Mine
authors.initials: M
authors.lastname: Can
authors.forename: Nurten
authors.initials: N
authors.lastname: Küçükmetin
authors.forename: Isil
authors.initials: I
authors.lastname: Tuzcuoglu
authors.forename: Serdar
authors.initials: S
authors.lastname: Tarhan
authors.forename: Cihan
authors.initials: C
authors.lastname: Göktan
authors.forename: Hakan
authors.initials: H
authors.lastname: Yüceyar
mesh_terms: D000328:Adult; D004386:Duodenum / Q000098:blood supply / Q000187:drug effects; D004932:Esophageal and Gastric Varices; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy*; D006439:Hemodynamics / Q000187:drug effects*; D006728:Hormones / Q000494:pharmacology* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012039:Regional Blood Flow; D013004:Somatostatin / Q000494:pharmacology* / Q000627:therapeutic use*; D013223:Statistics as Topic; D013270:Stomach / Q000098:blood supply / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D006728:Hormones; D013004:Somatostatin