MICHAEL R. FOGEL, M.D.; C. MICHAEL KNAUER, M.D.; LJUDEVIT L. ANDRES, M.D.; ANMOL S. MAHAL, M.D.; DAVID E. T. STEIN, M.D.; M. JUDITH KEMENY, M.D.; MARY M. RINKI, R.N.; JOANNE E. WALKER, R.N.; DAVID SIEGMUND, Ph.D.; PETER B. GREGORY, M.D.
Sixty patients with active upper gastrointestinal bleeding were randomized to receive either continuous intravenous infusions of vasopressin (29 patients) or placebo (31 patients) at a rate of 40 U/h. Six hours after beginning the study, 13 patients in the vasopressin group and 11 in the placebo group had ceased bleeding (p=0.46). By 24 hours, 17 patients in the vasopressin group and 14 in the placebo group had stopped bleeding (p=0.30). Restriction of the analysis to patients bleeding from varices showed no advantage with vasopressin treatment after 6 or 24 hours. No consistent trend favoring use of vasopressin to stop hemorrhage was noted during the 30-month study period. There was little difference between the two groups in the number of patients needing surgery (13 on vasopressin, 18 on placebo; p=0.30) or the number of deaths (eight on vasopressin, 11 on placebo; p=0.51); the transfusion requirement was the same. In our patients, a continuous intravenous infusion of vasopressin neither controlled bleeding nor altered outcome.
FOGEL MR, KNAUER CM, ANDRES LL, MAHAL AS, STEIN DET, KEMENY MJ, et al. Continuous Intravenous Vasopressin in Active Upper Gastrointestinal Bleeding: A Placebo-Controlled Trial. Ann Intern Med. ;96:565–569. doi: 10.7326/0003-4819-96-5-565
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Published: Ann Intern Med. 1982;96(5):565-569.
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