Intravenous (IV)
vasopressin has been used to control human upper gastrointestinal (GI)
hemorrhage for over 30 years. Although the use of
vasopressin has been studied extensively in adults, no study has evaluated its use in children.
Vasopressin was used therapeutically in 15 episodes of esophageal variceal
hemorrhage and two episodes of
bleeding peptic ulcer. Nine of 17 episodes were controlled with
vasopressin alone (53%). Balloon tamponade and variceal
sclerosis were required for control in the remainder. Blood requirements averaged 53 mL/kg prior to control of
hemorrhage. Metabolic complications occurred in 65% of the episodes. There were two groups of patients identified: those receiving greater or those receiving less than .01 units/kg/min of IV
vasopressin. All of the complications identified occurred when greater than .01 U/kg/min of
vasopressin were used (P less than .05). Control of
bleeding was not improved with higher doses of
vasopressin. These data suggest that the use of IV
vasopressin at doses greater than .01 U/kg/min to control GI
bleeding will increase the incidence of complications without improving control of
hemorrhage.