OCTREOTIDE BLUNTS POSTPRANDIAL SPLANCHNIC HYPEREMIA IN CIRRHOTIC-PATIENTS - A DOUBLE-BLIND RANDOMIZED ECHO-DOPPLER STUDY

The effect of octreotide, a long-acting synthetic analog of somatostat in, on fasting and postprandial splanchnic hemodynamics was investigat ed in cirrhotic patients, Splanchnic hemodynamics were assessed using an echo-Doppler duplex system in a prospective, double-blind, placebo- controlled, crossover study performed on 2 separate days, 1 week apart , in 30 cirrhotic patients. Measurements of portal vein (PV) cross-sec tional area (PV-A) and mean velocity (PV-V), and of superior mesenteri c artery (SMA) mean velocity (SMA-V) and pulsatility index (SMA-PI) (a n index of vascular resistance) were performed at baseline, 30 minutes after octreotide (200 mu g subcutaneously) or placebo administration, and 30 and 60 minutes after the ingestion of a liquid meal. In the fa sted state, octreotide induced a significant decrease in PV-V (-7%) an d in SMA-V (-10%) and an increase in PI (+16%). On the day of placebo administration, meal ingestion induced a significant increase in PV-V (+21%) and in SMA-V (+43%) and a decrease in PI (-21%). In contrast, m eal ingestion on octreotide day induced significantly smaller increase s in PV-V (+10%) and in SMA-V (+18%) and a significantly smaller decre ase in PI (-10%). Octreotide, although producing a mild reduction in P V-V and SMA-V in the fasted state, markedly blunts postprandial splanc hnic hyperemia in cirrhotic patients.