Continuous Intravenous Vasopressin in Active Upper Gastrointestinal Bleeding

Abstract

Patients [60] with active upper gastrointestinal bleeding were randomized to receive either continuous i.v. infusions of vasopressin (29 patients) or placebo (31) at a rate of 40 U/h. Six hours after beginning the study, 13 patients in the vasopressin group and 11 in the placebo group had ceased bleeding (P = 0.46). By 24 h, 17 patients in the vasopressin group and 14 in the placebo group had stopped bleeding (P = 0.30). Restriction of the analysis to patients bleeding from varices showed no advantage with vasopressin treatment after 6 or 24 h. No consistent trend favoring use of vasopressin to stop hemorrhage was noted during the 30-mo. study period. There was little difference between the 2 groups in the number of patients needing surgery (13 on vasopressin, 18 on placebo; P = 0.30) or the number of deaths (8 on vasopressin, 11 on placebo; P = 0.51); the transfusion requirement was the same. In these patients, a continuous i.v. infusion of vasopressin neither controlled bleeding nor altered outcome.