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Continuous Intravenous Vasopressin in Active Upper Gastrointestinal Bleeding: A Placebo-Controlled Trial

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.; and PETER B. GREGORY, M.D.
[+] Article and Author Information

Grant support: grant AM 19976, National Institute of Arthritis, Diabetes, Digestive, and Kidney Diseases.

▸Requests for reprints should be addressed to Peter B. Gregory, M.D.; Department of Medicine (111), Veterans Administration Medical Center, 3801 Miranda Avenue; Palo Alto, CA 94304.


Palo Alto, California


©1982 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1982;96(5):565-569. doi:10.7326/0003-4819-96-5-565
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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.

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