Somatostatin in Treatment of Haematemesis and Melaena

Somerville, K. W.; Davies, J.; Hawkey, Chris J.; Henry, David; Hine, K R; Langman, M. J. S.

doi:10.1016/s0140-6736(85)91903-8

Cited by 83 publications

(12 citation statements)

References 7 publications

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“…Five randomised controlled trials [76][77][78][79][80][81] have failed to demonstrate any beneficial effect of somatostatin in the control of UGI bleeding (table 1). However, these trials were not well designed since they: (i) included all patients with UGI bleeding irrespective of the source of haemorrhage, approximately 80% of which are known to cease bleeding spontaneously [30]; (ii) contained insufficient numbers of patients to make any definitive conclusions on the efficacy of somatostatin in this indication; (iii) excluded highrisk patients, and (iv) provided no information on the distribution of patients with stigmata indicative of early recurrent bleeding or death between the treatment groups.…”

Section: Non-specific Ugi Bleeding Somatostatin Vs H 2 -Receptor Antmentioning

confidence: 99%

Drug Therapy for Non-Variceal Upper Gastrointestinal Bleeding

Jenkins¹

1999

Digestion

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Section: Non-specific Ugi Bleeding Somatostatin Vs H 2 -Receptor Antmentioning

confidence: 99%

Drug Therapy for Non-Variceal Upper Gastrointestinal Bleeding

Jenkins¹

1999

Digestion

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“…Five randomised controlled trials [76][77][78][79][80] have failed to demonstrate any beneficial effect of somatostatin in the control of UGI bleeding (table 1) [81]. However, these trials were not well designed since they: (i) included all patients with UGI bleeding regardless of the source of haemorrhage, approximately 80% of which are known to cease bleeding spontaneously [30]; (ii) contained insufficient numbers of patients to make any definitive conclusions on the efficacy of somatostatin in this indication; (iii) excluded high-risk patients, and (iv) provided no information on the distribution of patients with stigmata indicative of early recurrent bleeding or death between the treatment groups.…”

Section: Comparative Studies Of Somatostatin and Octreotide In Ugi Blmentioning

confidence: 99%

Somatostatin in the Treatment of Non-Variceal Upper Gastrointestinal Bleeding

Jenkins

Poulianos

Coraggio

et al. 1998

Dig Dis

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The efficacies of somatostatin and octreotide have been widely studied in the control of bleeding from oesophageal varices. It has also been suggested that these drugs may be useful for the control of non-variceal upper gastrointestinal (UGI) bleeding, including that from peptic ulcers. In approximately 80% of patients presenting with non-variceal UGI bleeding, haemorrhage ceases spontaneously and does not recur. However, the remaining 20% of patients require active treatment. Results from recent studies have indicated that somatostatin is an effective treatment for the control of non-variceal UGI bleeding in high-risk patients, i.e. those in whom haemorrhage does not cease spontaneously or is likely to recur. In contrast there is no good evidence available at present to support a role for octreotide in this indication. The efficacy of somatostatin in controlling bleeding in patients with non-variceal UGI bleeding at high risk of mortality upon admission, or rebleeding following endoscopy, coupled with an excellent safety and tolerability profile, suggests that it may be a valuable therapeutic option in the management of non-variceal bleeding.

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“…The investigators postulated that the effect of somatostatin was related to decreased acid and pepsin output rather than a decrease in splanchnic flow. Somerville et alp [41] refuted the value of somatostatin in treating acute nonvariceal hemorrhage because they were unable to demonstrate significant benefit in 315 patients. Thus, the value of somatostatin is still not determined.…”

Section: Medical Therapymentioning

confidence: 99%

Acute Gastrointestinal Bleeding

Schaffner

1986

J Intensive Care Med

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A greater understanding of the pathophysiology of gastrointestinal bleeding has been accompanied by a rapid advancement in therapeutic technology. Newer endoscopic and radiologic techniques are being tested to determine their appropriate uses, but pharmacologic therapy has yet to be proved beneficial. A discussion of the newer as well as some traditional therapies is presented.The approach to treating the patient with gastrointestinal (GI) bleeding is changing with newer diagnostic techniques, pharmacotherapeutics, and technologic advances. Despite recent progress, GI bleeding is still a major cause of morbidity and mortality. As many as 10% of patients admitted to hospitals with GI bleeding die from the bleeding or its complications. It is hoped that some of the more recent additions to the therapeutic armamentarium will reduce this high mortality rate. The benefits of traditional methods of treatment as well as newer modes of therapy are discussed. AssessmentMonitoring the patient's vital signs is the most important means of assessing the degree of bleeding. The rate of bleeding as well as the volume of blood loss determines changes in vital signs. Patients may . lose up to 10 to 15 % of their blood volume without a change in pulse or blood pressure. However, with extremely rapid bleeding, a loss of as little as 10% of blood volume can result in clinical signs of shock. Generally, orthostatic changes in pulse and blood pressure occur with a 15 to 20% loss of circulating volume. Shock is almost invariably present when the patient loses more than 30% of the blood volume.When hemodynamic parameters are available, the first sign of bleeding is an increase in the pulmonary artery pressure [1]. Central venous pres-_ sure, pulmonary capillary wedge pressure, and arterial pressure were less reliable measures of blood loss in patients studied before, during, and after hemorrhage. When large volumes of replacement fluids are needed to stabilize the patient, central monitoring is required. Patients who are hemodynamically unstable after initial fluid replacement should also be monitored with at least a central venous catheter. Although a single measurement of central venous pressure may not be helpful, continuous readings can help gauge fluid replacement.

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Somatostatin in Treatment of Haematemesis and Melaena

Cited by 83 publications

References 7 publications

Drug Therapy for Non-Variceal Upper Gastrointestinal Bleeding

Drug Therapy for Non-Variceal Upper Gastrointestinal Bleeding

Somatostatin in the Treatment of Non-Variceal Upper Gastrointestinal Bleeding

Acute Gastrointestinal Bleeding

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