Wednesday, April 18, 2018

Octreotide and Somastostatin for UUGB

R.E.B.E.L. EM - Emergency Medicine Blog
R.E.B.E.L.EM - April 13, 2018 - Post Peer Reviewed By: Anand Swaminathan
"Recently I was asked to speak at the Texas College of Emergency Physicians (TCEP) conference April 2018. The particulars of this session were, five, 10 minute lectures on new indications for old drugs. My topic was the use of octreotide and somatostatin for undifferentiated upper gastrointestinal bleeding. This is a particular topic I have been getting more and more requests for, but didn’t really know the evidence behind why I was doing it. Does it help my patients or just another expensive medication, that takes up an IV with no clear patient oriented outcome?...
Clinical Bottom Line: Until newer studies are published showing either harm or no clinical benefit, at this time the use of octreotide in non-variceal upper gastrointestinal hemorrhage appears to benefit bleeding and need for surgery (Especially in the sickest patients: Hemodynamically unstable, requiring transfusion, large volume hematemesis). Unfortunately, we just do not have mortality data to help guide this decision nor do we know the optimal length of time to continue the infusion."