The therapeutic role of octreotide in the management of surgical disorders

Article Abstract:

Octreotide is a long-acting analogue of somatostatin, a hormone that has many physiologic effects including inhibiting the secretion of insulin and gastrin. This drug has recently been approved by the United States Food and Drug Administration. Octreotide is useful in treating malignant carcinoid syndrome and an intestinal secretory tumor. Octreotide may also be effective in treating other conditions such as esophageal varices (enlarged, swollen and tortuous veins at the lower end of the esophagus, often resulting from portal hypertension and liver cirrhosis). Other conditions for which octreotide is probably effective include: fistula (abnormal connection) between the intestine and the skin; pancreatic fistula; and dumping syndrome. This drug is being used experimentally to treat cancer, chronic pancreatitis (inflammation of the pancreas) and ERCP (endoscopic retrograde cholangiopancreatography) pancreatitis, and intestinal obstruction. Other experimental uses of octreotide are pain relief and imaging tumors. This drug is not effective in treating acute pancreatitis, or upper GI bleeding that is unrelated to esophageal varices. The most serious known side effect of octreotide is the possibility of increased risk of gallstones; however, this increased predisposition has not been clearly shown. In surgical patients, octreotide may cause certain adverse effects, such as cholecystitis and abnormal metabolism of nutrients. The effects of octreotide on wound healing are unknown and require further study. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Physiological aspects, Drug therapy, Carcinoid, Carcinoid tumor, Esophageal varices, Octreotide acetate, Fistula, Intestinal, Intestinal fistula

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Autotransfusion of unwashed mediastinal shed blood fails to decrease banked blood requirements in patients undergoing aortocoronary bypass surgery

Article Abstract:

As the public and medical communities become more aware of the risks of transmission of disease in transfusing contaminated blood, there have been efforts to avoid the use of donor (blood-bank) blood. The use of the patient's own blood, lost during operation and then reinfused, has been suggested as a possible way to decrease the use of banked blood. A study was undertaken to evaluate the impact of using a commercially available system for reinfusing shed, unwashed mediastinal blood (obtained from the patient's chest tubes) on the transfusion requirements of 96 patients undergoing heart surgery. The transfusion requirements of this group were compared with those of 78 historical control patients. In spite of the use of reinfused blood (autotransfusion), these patients still received more banked blood than the controls (an average of 2.7 units, compared with 2.0 units for controls). Blood transfusion was required in 68 percent of the autotransfusion group compared with 55 percent of the control group (not a significant difference). These results indicate that the use of autotransfusion of mediastinal shed blood does not decrease the number of transfusions of banked blood given, or reduce the percent of patients who require additional banked blood. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Evaluation, Prevention, Complications and side effects, Blood transfusion, Coronary artery bypass, Blood-borne diseases, Bloodborne diseases, Blood transfusion, Autologous, Autologous blood transfusion

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