Long-term haemodynamic effects of octreotide on postprandial splanchnic hyperemia in humans: a placebo-controlled echo-doppler study

Background: Octreotide is a potent splanchnic hypotensive somatostatin anal ogue effective in the treatment of acute variceal bleeding. Aim: To study the effects of octreotide on basal and postprandial splanchni c and systemic haemodynamics, and hormonal changes in humans, Methods: Twenty-four healthy volunteers were randomized to receive a liquid meal and either octreotide (OCT, 100 mu g bolus) or placebo repeatedly eve ry 4 h for 48 h, Splanchnic (Doppler ultrasound) and systemic haemodynamics (non-invasive cardiac monitoring) were assessed for 2 h on four consecutiv e days: one control day and after doses 1 (0 h), 7 (24 h) and 13 (48 h). Results: The maximum postprandial increases in mean blood velocity of the s uperior mesenteric artery (SMA-V-mean + 72%), portal (PBF + 52%) and total hepatic blood now (HBF + 50%) observed in the placebo group, were abolished after the first dose of octreotide (SMA-V-mean - 23%, P < 0.01; PBF - 22%, P < 0.01; HBF - 21%, P < 0.01). Postprandial hyperemia was restored at the end of the 48-h study period, but baseline SMA-V-mean (placebo 40 +/- 12, OCT 29 +/- 11 cm/s, P < 0.05) and PBF (placebo 1200 +/- 971, OCT 743 +/- 44 9 mL/min, P < 0.05) remained significantly lower in the octreotide group. T he postprandial decrease of systemic vascular resistance and increase of ca rdiac index were prevented by octreotide for 48 h. Conclusions: Repeated 4-hourly bolus injections of octreotide reduce splanc hnic blood flow for at least 48 h, but the prevention of food-induced splan chnic hyperemia is short-lasting.