Ranitidine Versus Ranitidine plus Octreotide in the Treatment of Acute Non-variceal Upper Gastrointestinal Bleeding: A Prospective Randomised Study

Archimandritis, Athanasios; Tsirantonaki, M; Tryphonos, M; Kourtesas, Dimitris; Sougioultzis, Stavros; Papageorgiou, Alexia; Tzivras, Michalis

doi:10.1185/030079900750120278

Cited by 6 publications

(3 citation statements)

References 24 publications

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“…Patients with the mean age of 61.2 ± 15 years of age were randomly assigned to receive 50 mg ranitidine every eight hours alone or 100 mcg octreotide every eight hours subcutaneously, concomitantly with ranitidine. Based on pathologic data from endoscopy, there were no differences between two groups [15]. Blood transfusion and hospital length of stay were not different in two groups.…”

Section: Discussionmentioning

confidence: 80%

Octreotide Safety and Efficacy in Pediatric Non-variceal Upper Gastrointestinal Bleeding, A Randomized Controlled Trial

Mirrahimi

Rohani

Moradi

et al. 2020

Preprint

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Background: Octreotide as somatostatin analogue decrease the production of gastrointestinal (GI) peptides. Its consumption in pediatric population has been limited to control of bleeding episodes with variceal origin. In this randomized controlled trial, we aim to assess octreotide as an add-on therapy to conventional regimen of proton pump inhibitors in controlling upper GI bleeding in pediatric population.Methods: In a prospective randomized controlled clinical trial, in Mofid Children's Hospital, Tehran, Iran, pediatric patients with age of 0 to 15 years diagnosed with acute non-variceal upper GI bleeding allocated to receive Octreotide or placebo and pantoprazole concomitantly. Medication administration initiated after patient’s stabilization. Patients with hepatic failure, liver stigma, coagulopathy thrombocytopenia etc. were excluded. Demographic, clinical and preclinical data were recorded in prepared sheets. All patients were followed until therapy discontinuation.Results: Forty-three patients with the mean age of 4.98 ± 3.79 years with confirmed non-variceal upper GI bleeding included to the study. Most patients had no specific etiology for their bleeding episode. Patients in intervention and control group received pantoprazole in comparable doses. No differences in baseline hemoglobin values was observed but final hemoglobin values were higher in intervention group. No differences in bleeding duration observed. In regard of adverse drug reaction due to octreotide infusion, none was observed in any patient. Conclusions: Our study demonstrated that octreotide does not alter bleeding duration but need for transfusion in non-variceal upper GI bleeding but it may have effect on amount of blood loss.Trial registration: The study was registered in Iranian Registry of Clinical Trial by the code of IRCT20120415009475N6.

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Section: Discussionmentioning

confidence: 80%

Octreotide Safety and Efficacy in Pediatric Non-variceal Upper Gastrointestinal Bleeding, A Randomized Controlled Trial

Mirrahimi

Rohani

Moradi

et al. 2020

Preprint

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“…The other 42 patients received ranitidine 100 mg intravenously every 12 h. The hemostasis rate was higher in the octreotide group (83.3%) than in the ranitidine group (54.8%) (P Ͻ 0.05). On the other hand, Archimandritis et al 15 showed that ranitidine plus subcutaneous octreotide was not superior to ranitidine alone in the management of patients with acute nonvariceal upper gastrointestinal bleeding in terms of use of blood units, days of hospitalization, and proportion of patients requiring emergency surgery. The hemostasis rate was 93.2% in the ranitidine alone group and 92.5% in the ranitidine plus octreotide group.…”

Section: Discussionmentioning

confidence: 97%

Extensive hemorrhagic erosive gastritis associated with acute pancreatitis successfully treated with a somatostatin analog

Yabuki

Maekawa

Satoh

et al. 2002

Journal of Gastroenterology

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In massive hemorrhage from acute gastric mucosal lesions, it is occasionally difficult to control the bleeding with nonsurgical therapy. We used the somatostatin analog, octreotide, which suppresses gastric and pancreatic function, to treat severe hemorrhagic erosive gastritis in a patient with acute pancreatitis. A 22-year-old man presented with epigastralgia and melena. Blood levels of pancreatitis markers were elevated. Computed tomography revealed diffuse enlargement of the pancreas, without fluid collection around the organ. An endoscopic examination showed extensive hemorrhagic erosions over almost the whole gastric mucosa. We diagnosed extensive hemorrhagic erosive gastritis with acute pancreatitis. A protease inhibitor (nafamostat mesilate 50 mg/day) and an H(2) receptor antagonist (famotidine 40 mg/day) were administered by injection for 6 days; the patient's serum and urine amylase levels fell, but the gastric erosions with hemorrhage were not attenuated. Octreotide was given subcutaneously, at a daily dose of 100 microg for 5 days, without famotidine administration. His melena disappeared, and the gastric erosions were markedly decreased. Administration of the somatostatin analog, octreotide, proved to be effective treatment in a patient with severe hemorrhagic erosive gastritis associated with acute pancreatitis.

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“…Octreotide use is standard of care for variceal bleeding. It is not recommended for routine use in nonvariceal bleeding (8) due to lack of improvement in length of hospitalization and rebleeding in adults (22)(23)(24). There are only a few studies observing effect of octreotide in nonvariceal bleeding in children (25).…”

Section: Discussionmentioning

confidence: 99%

Endoscopy in Infants With Gastrointestinal Bleeding Has Limited Diagnostic or Therapeutic Benefit

Bose

Jacobs

Cordova

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objectives: Pediatric gastroenterologists are often consulted to perform diagnostic and therapeutic endoscopy in infants with gastrointestinal bleeding (GIB). The value of endoscopy and risk of complications in this population are not well characterized. We aimed to describe findings and outcomes of infants with GIB who undergo endoscopy. Methods: Retrospective, single-center, cohort study of hospitalized infants ≤12 months who underwent esophagogastroduodenoscopy (EGD) and/or colonoscopy/flexible sigmoidoscopy (COL) for GIB. Current procedural technology codes, international classification of diseases codes, and quality control logs identified infants. Results: Fifty-six infants were identified from 2008 to 2019 (51.8% female; mean age 161.6 days). Seven endoscopies identified sources of GIB: gastric ulcers, a duodenal ulcer, gastric angiodysplasia, esophageal varices, and an anastomotic ulcer. Three infants underwent therapeutic interventions of banding/sclerotherapy of esophageal varices and triamcinolone injection of an anastomotic ulcer. Six infants underwent abdominal surgery for GIB or suspected intestinal perforation after endoscopy, where a gastric perforation, jejunal perforation at an anastomotic stricture, necrotizing enterocolitis totalis with perforation, Meckel’s diverticulum, and a duodenal ulcer were identified. No source of bleeding was identified surgically in 1 infant with GIB. Respiratory failure, use of vasopressors or octreotide, administration of blood products, and high blood urea nitrogen were associated with increased likelihood of requiring surgery (P < 0.05 for all). Conclusions: There was limited utility to performing endoscopy in infants ≤12 months old with clinical GIB. Endoscopy in these sick infants carries risk, and 3 infants in this series presented with a gastrointestinal (GI) perforation shortly after the procedure. These limitations and risks should influence clinical decision-making regarding endoscopy in infants with GIB.

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Ranitidine Versus Ranitidine plus Octreotide in the Treatment of Acute Non-variceal Upper Gastrointestinal Bleeding: A Prospective Randomised Study

Abstract: Ranitidine plus subcutaneous octreotide is not superior to ranitidine alone in the management of patients with acute non-variceal UGI bleeding.

Cited by 6 publications

References 24 publications

Octreotide Safety and Efficacy in Pediatric Non-variceal Upper Gastrointestinal Bleeding, A Randomized Controlled Trial

Octreotide Safety and Efficacy in Pediatric Non-variceal Upper Gastrointestinal Bleeding, A Randomized Controlled Trial

Extensive hemorrhagic erosive gastritis associated with acute pancreatitis successfully treated with a somatostatin analog

Endoscopy in Infants With Gastrointestinal Bleeding Has Limited Diagnostic or Therapeutic Benefit

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