Procon debate Octreotide has an important role in the treatment of gastrointestinal bleeding of unknown origin 英文参考文献.docVIP
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Procon debate Octreotide has an important role in the treatment of gastrointestinal bleeding of unknown origin 英文参考文献
Available online /content/10/4/218
Review
Pro/con debate: Octreotide has an important role in the
treatment of gastrointestinal bleeding of unknown origin?
Yaseen Arabi1, Bandar Al Knawy2, Alan N Barkun3 and Marc Bardou4
1Intensive Care Unit, King Abdulaziz Medical City, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426,
Saudi Arabia
2Division of Gastroenterology/Hepatology, Department of Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
3Divisions of Gastroenterology and Clinical Epidemiology, McGill University, and the McGill University Health Centre, Montréal, Québec, Canada
4Division of Clinical Pharmacology, LPPCE, Faculty of Medicine, Dijon Cedex, France
Corresponding author: Alan Barkun, alan.barkun@muhc.mcgill.ca
Published: 3 July 2006
Critical Care 2006, 10:218 (doi:10.1186/cc4958)
This article is online at /content/10/4/218
? 2006 BioMed Central Ltd
Abstract
Clinical scenario
A 59 year old male has been admitted to the intensive care unit
with febrile neutropenia and septic shock. The patient has been
diagnosed with acute myelogenous leukemia and following
induction is pancytopenic. He is mechanically ventilated and
receiving H2 antagonists. You are called because the patient is
having large amounts of melena and a modest amount of blood
returning from his nasogastric tube. He is hemodynamically
unstable. You transfuse blood, platelets and plasma as
appropriate, and start an intravenous proton pump inhibitor.
Endoscopy cannot be performed until the following day. You
have to decide whether to treat the patient empirically with
intravenous octreotide. You know it has a role in certain types
of gastrointestinal (GI) bleeding but you are uncertain if you
should be using it when the cause of bleeding is unclear. Your
administrator tells you the drug is relatively expensive.
Whether it is the primary reason for admission
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