Selective Intra-arterial Vasopressin

Publisher Website
Google Scholar
Abstract
A retrospective analysis of 66 patients over a 3 yr period receiving selective intra-arterial vasopressin (SIAV) for control of 69 episodes of massive gastrointestinal bleeding is presented. SIAV was used when conventional medical therapy failed and the patient''s pathology and/or complicating medical conditions necessitated an attempt at controlling an emergent condition by nonoperative means. Hemorrhage was completely controlled in 43% of variceal hemorrhages, 67% of hemorrhage gastritis, 45% of bleeding ulcers and in 62% of colonic sources. The incidence of rebleeding following initial treatment was 16%. Surgical mortality for patients who were initial failures of SIAV was 50%. Patients undergoing elective surgery after complete control by SIAV had an 8% mortality. There were 5 catheter-related complications. Minor complications in 41% of patients required no treatment. Major complications occurred in 40% of cirrhotic and 21% of noncirrhotic bleeding episodes; and contributed to 5 cirrhotic deaths and 3 noncirrhotic deaths. In critically ill patients in an Intensive Care Unit, SIAV appears to be effective in controlling certain types of gastrointestinal hemorrhage and increase survival rate.