mohammad parohan

Acute gastrointestinal bleeding is one of the critical emergencies with good prognosis if properly managed. Combination of drug has had the best possible clinical results to stabilize the hemodynamic status of these patients. Therefore, in this study, the short-term consequences of simultaneous administration of vasopressin and tranexamic acid were compared.

In this double-blind clinical trial study that was conducted from November 2018 to November 2019 at Valiasr Hospital in Arak 120 eligible patients with acute gastrointestinal bleeding were included. Patients were divided into four groups of 30. In the first group (TXA) the common treatment with tranexamic acid was first infused at the rate of 10mg/kg as an initial dose over 20 minutes and then received to 1mg/kg per hour as a maintenance dose for up to four hours. The second group (VP group) received common treatment with infusion of 30 units per hour for six hours. The third group (R group) received only conventional treatments and the fourth group (TXA+VP group) received both tranexamic acid and vasopressin along with conventional treatment. The amount of light blood lose and vital signs including blood pressure and heart rate and Hg, BUN , CR , NA, K, BS, PT, PTT, INR were checked.

In this study, the vasopressin group had a greater decrease in hemoglobin (p≤0.05), the increase in blood urea was less in the two groups that received vasopressin than the other two groups (p≤0.05). The group of tranexamic acid had much better conditions than the group of vasopressin, in terms of hematochezia or hematemesis interruption, need for blood transfusion, re-bleeding, need for endoscopy and emergency surgery, and adding vasopressin to tranexamic acid also led to improved outcomes (p≤0.05).

It seems that the concurrent use of tranexamic acid and vasopressin in upper gastrointestinal bleeding improves renal function and stops bleeding and reduces the risk of re-bleeding, the need for blood transfusion and endoscopic and surgical intervention. Its long-term results need further study.