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July 1988

High-Dose Vasopressin for Acute Variceal HemorrhageClinical Advantages Without Adverse Effects

Author Affiliations

From the Department of Surgery, The University of Texas Health Science Center and The Audie L. Murphy Veterans Administration Hospital, San Antonio, Tex.

Arch Surg. 1988;123(7):876-880. doi:10.1001/archsurg.1988.01400310090015

• Based on laboratory and clinical data from our institution, 113 patients with cirrhosis, portal hypertension, and acute hemorrhage from esophageal varices were treated with high-dose vasopressin arginine (1 to 1.5 U/min) to control the acute bleeding and reduce blood loss during portosystemic shunt operations. Compared with patients receiving a lower dose of vasopressin infusion, these patients had a reduction in both postoperative mortality (21% vs 6%) and the proportion of patients requiring emergency operation (40% vs 18%). A decrease in operative blood loss (1340 vs 793 mL) was also seen. Adverse effects of vasopressin were increased by high-dose infusion, but no significant morbidity occurred. These results suggest that high-dose vasopressin infusion can reduce the mortality of acute variceal hemorrhage and portosystemic shunting primarily by allowing patients to improve hepatic function prior to an elective operation and by decreasing intraoperative blood loss.

(Arch Surg 1988;123:876-880)