The effect of octreotide on gastroduodenal blood flow measured by laser Doppler flowmetry in rabbits and man

OBJECTIVE:The somatostatin analogue, octreotide is valuable in the management of variceal bleeding, and it has been suggested that it may stop peptic ulcer hemorrhage by reducing gastroduodenal blood flow or increasing intragastric pH. The aim of this study was to determine the effect of intravenous octreotide infusion on gastroduodenal mucosal blood flow and gastric pH.METHODS:Seven New Zealand white rabbits and five healthy human volunteers were used. Mucosal blood flow was measured using a laser Doppler flowmeter (LDF). The Doppler probe was positioned in the upper gastrointestinal tract of the seven rabbits and five human volunteers. Blood flow was measured before and after octreotide infusion.RESULTS:In the animal experiments, mucosal blood flow was decreased in a dose dependent manner in the gastric body (209.1–56.3 U) (p < 0.008), antrum (143.3–33.3 U) (p < 0.02) and duodenum (254–67.6 U) (p < 0.016) by doses of octreotide ranging from 10–50 μg/kg of body weight. In the human studies, mucosal blood flow was decreased in the gastric body (p < 0.016) and antrum (p < 0.009) after octreotide infusion (dose 1–1.5 μg/kg). Intragastric pH was significantly increased (p < 0.05). The change was not associated with systemic hemodynamic changes.CONCLUSIONS:Gastroduodenal mucosal blood flow was reduced and intragastric pH increased by octreotide. This agent could be helpful in the management of gastroduodenal mucosal bleeding.

[1]  M. Gales,et al.  Octreotide or Vasopressin for Bleeding Esophageal Varices , 1997, The Annals of pharmacotherapy.

[2]  H. Wong,et al.  Roles of gastrin and somatostatin in the regulation of gastric acid secretion in the fetal rabbit. , 1996, The Journal of surgical research.

[3]  G. delle Fave,et al.  Oxyntic endocrine cells of hypergastrinaemic patients. Differential response to antrectomy or octreotide. , 1996, Gut.

[4]  G. delle Fave,et al.  Effectiveness of octreotide in controlling fasting hypergastrinemia and related enterochromaffin-like cell growth. , 1996, The Journal of clinical endocrinology and metabolism.

[5]  J. Lau,et al.  Prospective randomised study of effect of octreotide on rebleeding from oesophageal varices after endoscopic ligation , 1995, The Lancet.

[6]  S. Kawano,et al.  Gastric blood flow in ulcer diseases. , 1995, Scandinavian journal of gastroenterology. Supplement.

[7]  K. Hirabayashi,et al.  Octreotide decreases canine gastric mucosal blood flow: a controlled assessment by endoscopic reflectance spectrophotometry. , 1994, Gastrointestinal endoscopy.

[8]  A. M. Wheatley.  Limitations of laser-Doppler velocimetry and reflectance spectrophotometry in estimating gastric mucosal blood flow. , 1993, The American journal of physiology.

[9]  J. Rodés,et al.  Increased gastric mucosal perfusion in cirrhotic patients with portal hypertensive gastropathy. , 1992, Gastroenterology.

[10]  R. Shields,et al.  Management of massive upper gastrointestinal haemorrhage from multiple sites of peptic ulceration with somatostatin and octreotide--a report of five cases. , 1992, Gut.

[11]  M. Halliwell,et al.  Fasting and post-prandial splanchnic blood flow is reduced by a somatostatin analogue (octreotide) in man. , 1991, Clinical science.

[12]  N. Afdhal,et al.  Clot lysis by gastric juice: an in vitro study. , 1989, Gut.

[13]  C. Piasecki,et al.  Ulcers produced by ligation of individual gastric mucosal arteries in the guinea pig. , 1989, Gastroenterology.

[14]  J. Christiansen,et al.  Placebo-controlled trial with the somatostatin analogue SMS 201-995 in peptic ulcer bleeding. , 1989, Gastroenterology.

[15]  Z. Tulassay,et al.  Somatostatin versus cimetidine in the treatment of actively bleeding duodenal ulcer: a prospective, randomized, controlled trial. , 1989, The American journal of gastroenterology.

[16]  K. Kvernebo,et al.  Gastric blood flow in patients with gastric ulcer measured by endoscopic laser Doppler flowmetry. , 1988, Scandinavian journal of gastroenterology.

[17]  R. Pérez-Ayuso,et al.  Somatostatin compared with cimetidine in the treatment of bleeding peptic ulcer without visible vessel , 1988, Alimentary pharmacology & therapeutics.

[18]  T. Gana,et al.  Focal gastric mucosal blood flow by laser-Doppler and hydrogen gas clearance: a comparative study. , 1987, The Journal of surgical research.

[19]  T. Sparnon.  Somatostatin in the treatment of severe upper gastrointestinal bleeding: A multicentre controlled trial , 1987 .

[20]  J. Matthews,et al.  The effect of acid perfusion on mucosal blood flow and intramural pH of rabbit duodenum. , 1987, Surgery.

[21]  C. Goresky,et al.  Chronic mesenteric vascular insufficiency with gastric ulceration. , 1986, Gastroenterology.

[22]  J. Wahern.  The influence of a Long-acting samatostatin analogue on splanchnic haemodynamics and metabolism in healthy subjects and patients with liver cirrhosis , 1986 .

[23]  J. Wahren,et al.  The influence of a long-acting somatostatin analogue on splanchnic haemodynamics and metabolism in healthy subjects and patients with liver cirrhosis. , 1986, Scandinavian journal of gastroenterology. Supplement.

[24]  R. Shields,et al.  Effects of a somatostatin analogue SMS 201‐995 on hepatic haemodynamics in the pig and on intravariceal pressure in man , 1985, The British journal of surgery.

[25]  R. Shields,et al.  The effects of a somatostatin analogue SMS 201‐995 on hepatic haemodynamics in the cirrhotic rat , 1985, The British journal of surgery.

[26]  A. P. Shepherd,et al.  Laser-Doppler, H2 clearance, and microsphere estimates of mucosal blood flow. , 1985, The American journal of physiology.

[27]  E G Salerud,et al.  Evaluation of laser Doppler flowmetry in the assessment of intestinal blood flow in cat. , 1985, Gastroenterology.

[28]  K. Uvnäs‐Moberg,et al.  Randomised double blind trial of somatostatin in the treatment of massive upper gastrointestinal haemorrhage. , 1985, Gut.

[29]  K. Hine,et al.  SOMATOSTATIN IN TREATMENT OF HAEMATEMESIS AND MELAENA , 1985, The Lancet.

[30]  S. Lombardi,et al.  Somatostatin and ranitidine in the control of iatrogenic haemorrhage of the upper gastrointestinal tract. , 1984, British medical journal.

[31]  A. Parisi,et al.  Somatostatin in the treatment of severe gastrointestinal bleeding from peptic origin. A multicentric controlled trial. , 1984, The Italian journal of surgical sciences.

[32]  A. Sonnenberg,et al.  Somatostatin reduces gastric mucosal blood flow in normal subjects but not in patients with cirrhosis of the liver. , 1983, Gut.

[33]  B. Schölkens,et al.  A microsphere study on the effects of somatostatin and secretin on regional blood flow in anesthetized dogs , 1982, Regulatory Peptides.

[34]  H. Fusamoto,et al.  Gastric mucosal hemodynamics after thermal or head injury. A clinical application of reflectance spectrophotometry. , 1982, Gastroenterology.

[35]  A. P. Shepherd,et al.  Continuous measurement of intestinal mucosal blood flow by laser-Doppler velocimetry. , 1982, The American journal of physiology.

[36]  G. Sonnenberg,et al.  Effect of somatostatin on splanchnic hemodynamics in patients with cirrhosis of the liver and in normal subjects , 1981 .

[37]  W. Silen,et al.  H+ back diffusion stimulating gastric mucosal blood flow in the rabbit fundus. , 1981, Surgery.

[38]  B. Limberg,et al.  SOMATOSTATIN FOR CIMETIDINE-RESISTANT GASTRODUODENAL HÆMORRHAGE , 1980, The Lancet.

[39]  G. Stalder,et al.  [Somatostatin and cimetidine in peptic ulcer hemorrhage. A randomized controlled study]. , 1980, Zeitschrift fur Gastroenterologie.

[40]  M. Wall,et al.  SOMATOSTATIN AND CIMETIDINE IN PEPTIC-ULCER HÆMORRHAGE A Randomised Controlled Trial , 1980, The Lancet.

[41]  J. Johnston,et al.  DDAVP in the prevention of headache after lumbar puncture. , 1980, British medical journal.

[42]  T. Kamada,et al.  Measurement of hemoperfusion and oxygen sufficiency in gastric mucosa in vivo. Evidence of mucosal hypoxia as the cause of hemorrhagic shock-induced gastric mucosal lesion in rats. , 1979, Gastroenterology.

[43]  E. Kivilaakso,et al.  Relationship between ulceration and intramural pH of gastric mucosa during hemorrhagic shock. , 1978, Surgery.

[44]  M. Vatn,et al.  A SMALL DOSE OF SOMATOSTATIN INHIBITS THE PENTAGASTRIN STIMULATED GASTRIC SECRETION OF ACID, PEPSIN AND INTRINSIC FACTOR IN MAN , 1978, Clinical endocrinology.

[45]  H. Becker,et al.  The role of ischemia in the pathogenesis of stress induced gastric lesions in piglets. , 1978, Surgery, gynecology & obstetrics.

[46]  J. H. Baron,et al.  Proceedings: Inhibition of gastrin and gastric acid by growth hormone release inhibiting hormone. , 1975, Gut.

[47]  A. Sivula,et al.  Gastric ulceration following experimentally induced hypoxia and hemorrhagic shock: in vivo study of pathogenesis in rabbits. , 1966, Annals of surgery.

[48]  J. Richardson.  Addisonian anæmia following entero‐anastomosis , 1945 .

[49]  T. B. Curling,et al.  On acute ulceration of the duodenum, in cases of burn. , 1842, Medico-chirurgical transactions.