Acute hemodynamic effects of octreotide and terlipressin in patients with cirrhosis: A randomized comparison

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

Research output: Contribution to journalArticlepeer-review

90 Citations (Scopus)

Abstract

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

Original languageEnglish
Pages (from-to)631-635
Number of pages5
JournalAmerican Journal of Gastroenterology
Volume100
Issue number3
DOIs
Publication statusPublished - 2005 Mar

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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