Intraarterial
vasopressin has been reported to be effective in the treatment of massive upper
gastrointestinal hemorrhage. A prospective, controlled clinical trial comparing conventional treatment with conventional
therapy plus intraarterial
vasopressin was undertaken. Sixty episodes of upper
gastrointestinal hemorrhage were evaluated during a 40-month period; 32 received conventional and 28 conventional plus
vasopressin therapy. The two groups of patients were similar in type and severity of their
bleeding lesions and in their underlying diseases.
Vasopressin was more effective in controlling
hemorrhage from nonvariceal lesions (P less than 0.05) and from
varices (P less than 0.01) than conventional
therapy. Transfusion requirements were significantly reduced in those patients who received
vasopressin. Paradoxically, survival was not affected by
vasopressin administration. The failure of cessation of
hemorrhage to improve survival is thought to be due to the degree of advancement of the underlying disease, to the torrential nature of the
hemorrhage, to the frequency of recurrent
hemorrhage, and to the use of intraarterial
vasopressin in some patients in the conventional treatment group in whom conventional
therapy had failed.