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Use of Vasoactive Drugs for Acute Variceal Bleeding

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Variceal Hemorrhage

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Abstract

Acute variceal bleeding is a severe complication of portal hypertension and a major cause of death in patients with hepatic cirrhosis. Although during the last decades survival has been improved, through implementation of effective treatments and standardization of general medical care, mortality still remains about 15–20 %. Current recommended standard of care for patients with acute variceal bleeding is a combined treatment with vasoactive drugs, prophylactic antibiotics, and endoscopic procedures. Vasoactive drugs such as terlipressin, somatostatin, and octreotide have a leading role in the management of variceal bleeding since they improve the control of bleeding and consequently reduce the risk of mortality, transfusion requirements, and duration of hospital stay. This chapter focuses on the rationale for the use of drug therapy, its pharmacological and hemodynamic properties, and its clinical use.

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Authors and Affiliations

  1. Hepatic Hemodynamic Laboratory, Hospital Clínic de Barcelona and CIBERehd, Barcelona, Spain

    Stefania Casu M.D., Annalisa Berzigotti M.D., Ph.D. & Jaime Bosch M.D., Ph.D., F.R.C.P.

  2. Hepatic Hemodynamic Laboratory, Hospital Clinic, University of Barcelona and CIBERehd, Villarroel 170, Barcelona, 08036, Spain

    Jaime Bosch M.D., Ph.D., F.R.C.P.

Authors
  1. Stefania Casu M.D.
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  2. Annalisa Berzigotti M.D., Ph.D.
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  3. Jaime Bosch M.D., Ph.D., F.R.C.P.
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Correspondence to Jaime Bosch M.D., Ph.D., F.R.C.P. .

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Editors and Affiliations

  1. Luigi Sacco University Hospital, University of Milan, Milan, Italy

    Roberto de Franchis

  2. Ospedale Universitario Luigi Sacco, Universitá degli Studi di Milano, UOC Gastroenterologia, Milano, Italy

    Alessandra Dell’Era

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Casu, S., Berzigotti, A., Bosch, J. (2014). Use of Vasoactive Drugs for Acute Variceal Bleeding. In: de Franchis, R., Dell’Era, A. (eds) Variceal Hemorrhage. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0002-2_11

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