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Long‐term haemodynamic effects of octreotide on postprandial splanchnic hyperemia in humans: a placebo‐controlled echo–doppler study
Author(s) -
D. Ludwig,
S Terai,
Andreas Brüning,
Eduard F. Stange
Publication year - 1999
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.1999.00583.x
Subject(s) - medicine , postprandial , splanchnic , octreotide , splanchnic circulation , placebo , hemodynamics , superior mesenteric artery , bolus (digestion) , anesthesia , endocrinology , cardiology , somatostatin , insulin , pathology , alternative medicine
Background : Octreotide is a potent splanchnic hypotensive somatostatin analogue effective in the treatment of acute variceal bleeding. Aim : 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 μg 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–V mean + 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–V mean – 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–V mean (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.