Effect of Somatostatin on Splanchnic Hemodynamics in Patients with Liver Cirrhosis and Portal Hypertension

Abstract

The effect of somatostatin on splanchnic hemodynamics in patients with liver cirrhosis is not clearly defined, as some authors report a decrease in portal pressure and in liver blood flow during intravenous administration of this hormone, while others do not. In 19 subjects with liver cirrhosis and portal hypertension the following parameters were measured before and during intravenous administration of somatostatin (7.5 μg/min): porto-hepatic gradient, estimated hepatic blood flow, specific splenic blood flow, cardiac index. Estimated hepatic blood flow decreased significantly during somatostatin infusion (p < 0.05), averaging a 13% decrease; porto-hepatic gradient, splenic specific blood flow and cardiac index did not vary significantly. These data indicate that somatostatin infused at a dose of 7.5 μg/min induces a slight decrease in liver blood flow without affecting portal hypertension.

Effect of nadolol on liver haemodynamics and function in patients with cirrhosis.

“…Steady state was considered to have been achieved when the difference between ICG arterial concentrations was less than 5%. The procedure has been extensively described elsewhere (Gatta et al, 1984;Merkel et al, 1985b).…”

Somatostatin for Upper Gastrointestinal Hemorrhage and Pancreatic Surgery

“…Somatostatin was found to reduce splanchnic blood flow in healthy subjects [47][48][49], reduce hepatic blood flow [50], hepatic venous pressure gradient (HVPG) [51][52][53][54] and reduce AzBF in cirrhotic patients [54], the latter more markedly than vasopressin. Only the reduction in AzBF has been a consistent finding, however.…”

“…0.05 versus baseline value. effect on portal pressure [50][51][52][53][54][55] or intravariceal pressure [56]. Bolus injection appears to have important hemodynamic effects as compared to constant infusion (table 5), and may be the preferred method of administration [57].…”

Pharmacological Treatment of Acute Variceal Bleeding

“…Thus the available data on terlipressin indicates that it is highly effective in conSomatostatin and Octreotide trolling bleeding, has been shown to reduce mortality, and is simpler to administer than vasopressin with subSomatostatin is a 14-amino acid peptide, that was found to reduce splanchnic blood flow in normal humans stantially fewer side effects. However, it is not licensed in the United States for use in bleeding oesophageal varices, [45][46][47], reduce hepatic blood flow [48], hepatic venous pressure gradient (HVPG) [49][50][51][52] and reduce azygous almost certainly due to criticism of the placebo-controlled studies. The trial by Walker et al [37] included other blood flow in cirrhotics [52], the latter more markedly than with vasopressin.…”

“…The trial by Walker et al [37] included other blood flow in cirrhotics [52], the latter more markedly than with vasopressin. Only the reduction in azygous flow therapies, the timing of which is unclear, and the other 2 trials are hampered by insufficient patient numbers to has been a consistent finding -others have found no effect on portal pressure [48][49][50][51][52][53] or intravariceal pressure avoid a type 2 error. These issues will be addressed in forthcoming trials.…”