Octreótido long acting release para la hemorragia digestiva en pacientes de edad avanzada con comorbilidad

Infante, Javier Molina; Gallardo, Belen Perez; Alonso, Moises Hernandez; Rodriguez, Jose M. Mateos; Sadornil, C Dueñas; Bermejo, Miguel Fernández

doi:10.1016/j.medcli.2009.07.013

Cited by 25 publications

(3 citation statements)

References 9 publications

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“…However, due to its adverse effect profile, it is less used. Somatostatin and it's analogue, octreotide, are on the other hand associated with fewer side effects [50].…”

Section: Recommendations For Management Of Site-specific Bleedingmentioning

confidence: 99%

“…- q.i.d.Intravenous[[40], [41], [42]] Upper gastrointestinal bleeding Therapy Posology Administration Adverse effects Contra-indications Ref. Tranexamic acid1–1.5 g t.i.d.OralNausea, vomiting and diarrhoea (25%)Colour vision disturbanceDose reduction if GFR < 50 ml/mnActive thromboembolic disease[47]10–15 mg/kg t.i.d.IntravenousOctreotide100–200 mg t.i.d.Subcutaneous?None[50]10 mcg push then 25 mcg/hIntravenousIf > 100 mcg/h: nausea, abdominal discomfort, diarrhoea Rectal bleeding Therapy Posology Administration Adverse effects Contra-indications Ref. Tranexamic acid500 mg, 10 ml water b.i.d.Rectal (enema)??[53]1 g t.i.d.OralNausea, vomiting and diarrhoea (25%)Colour vision disturbanceDose reduction if GFR < 50 ml/mnActive thromboembolic disease[31] Vesical bleeding Therapy Posology Administration Adverse effects Contra-indications …”

Section: Summary Of Treatments For Site-specific Bleeding Managementmentioning

confidence: 99%

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Management of bleeding in palliative care patients in the general internal medicine ward: a systematic review

Sood¹,

Mancinetti

Betticher³

et al. 2020

Annals of Medicine and Surgery

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BackgroundPalliative care patients, those suffering from at least one chronic lifelong medical condition and hospice care patients, those with a life expectancy less than 6 months, are regularly hospitalised in general internal medicine wards. By means of a clinical case, this review aims to equip the internist with an approach to bleeding in this population. Firstly, practical advice on platelet transfusions will be provided. Secondly, the management of bleeding in site-specific situations will be addressed (from the ENT/pulmonary sphere, gastrointestinal - urogenital tract and cutaneous ulcers). Finally, an algorithm pertaining to the management of catastrophic bleeding is proposed.MethodsElectronic databases, including EMBASE, Pubmed, Google Scholar and the Cochrane Library were studied as primary resources, in association with local guidelines, to identify papers exploring platelet transfusions and alternative management of site-specific bleeding in palliative care patients.ResultsHaemorrhagic complications are frequent in palliative care patients in the internal medicine ward. Current guidelines propose a therapeutic-only platelet transfusion policy. Nonetheless, prophylactic and/or therapeutic transfusion remains a physician-dependent decision. Site-specific therapeutic options are based on expert opinion and case reports. While invasive measures may be pertinent in certain situations, their application must be compatible with patient goals. Catastrophic bleeding requires caregivers' comforting presence; pharmacological management is secondary.ConclusionLiterature is lacking regarding management of bleeding in the palliative care population hospitalised in an acute medical setting. Recommendations are of limited quality, the majority based on case reports or expert opinion. Further studies, exploring for example the impact on patient quality of life, are desirable to improve the management of this frequently encountered complication.

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“…However, due to its adverse effect profile, it is less used. Somatostatin and it's analogue, octreotide, are on the other hand associated with fewer side effects [50].…”

Section: Recommendations For Management Of Site-specific Bleedingmentioning

confidence: 99%

Section: Summary Of Treatments For Site-specific Bleeding Managementmentioning

confidence: 99%

Management of bleeding in palliative care patients in the general internal medicine ward: a systematic review

Sood¹,

Mancinetti

Betticher³

et al. 2020

Annals of Medicine and Surgery

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show abstract

“…Small bowell angioectasias commonly occur in elderly patients [6] with several underlying co-morbidities such as cardiovascular disease, chronic liver and kidney disease [7]. In addition, these patients are very often on anticoagulants or anti-platelets which increase the bleeding tendency of the vascular lesions [8].…”

Section: Introductionmentioning

confidence: 99%

Refractory Anaemia Secondary to Small Bowel Angioectasias - Comparison between Endotherapy Alone versus Combination with Somatostatin Analogues

Zammit

Sidhu

Sanders

2017

JGLD

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Background & Aims: Patients with small bowel angioectasias (SBAs) can be difficult to manage as they are generally elderly with multiple co-morbidities. Angioectasias are multiple and tend to recur. Argon plasma coagulation (APC), despite being a commonly used method to treat these patients has an associated persistent rate of re-bleeding necessitating additional treatment to manage these patients.Methods: All patients with refractory iron deficiency anaemia secondary to SBAs were retrospectively subdivided into two groups. Patients in group 1 were managed with double balloon enteroscopy (DBE) and APC alone and those in group 2 received Lanreotide in addition to DBE and APC.Results: A total of 49 patients were included in this study: group 1: 37 patients (75.5%), group 2: 12 patients (24.5%). All had significant comorbidities and the mean duration of anaemia was 114.3, SD 307.0 months. Significant improvements in haemoglobin (Hb) (11g/L vs 3.2g/L p=0.043), transfusion requirements per month (0.8 vs 4.7 p=0.052) and mean bleeding episodes (1.08 vs 2.6 p=0.032) were demonstrated in group 2 when compared to group 1. One patient developed symptomatic gallstone disease and one patient stopped Lanreotide due to a lack of response.Conclusions: This is the first study comparing endotherapy to a combination of endotherapy and pharmacotherapy. It shows a significantly better outcome in patients receiving a combination of endotherapy and Lanreotide. Lanreotide can be a safe additional treatment in patients not responding to APC alone.Abbreviations: APC: argon plasma coagulation; CE: capsule endoscopy; DBE double balloon enteroscopy; Hb: hemoglobin; OGIB: over gastrointestinal bleeding; SBAs: small bowel angioectasias.

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Angiodysplasies hémorragiques du tube digestif

Rahmi

2014

Acta Endosc

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Octreótido long acting release para la hemorragia digestiva en pacientes de edad avanzada con comorbilidad

Cited by 25 publications

References 9 publications

Management of bleeding in palliative care patients in the general internal medicine ward: a systematic review

Management of bleeding in palliative care patients in the general internal medicine ward: a systematic review

Refractory Anaemia Secondary to Small Bowel Angioectasias - Comparison between Endotherapy Alone versus Combination with Somatostatin Analogues

Angiodysplasies hémorragiques du tube digestif

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