Octreotide Plus Proton pump inhibitor (PPI) versus PPI alone in Non-Variceal Upper gastrointestinal (GI) Bleeding in intensive care unit (ICU): A Multi-Center Randomized Trial.

PURPOSE: To compare clinical outcomes between PPI therapy alone and PPI combined with octreotide in patients with acute upper gastrointestinal bleeding.

METHODS

This prospective, randomized, double-blind, multi-center study included 56 patients allocated to either PPI alone or PPI plus octreotide. Baseline demographics and comorbidities were comparable between groups. Laboratory parameters were assessed over three days. Clinical outcomes included rebleeding, transfusion requirements, mechanical ventilation, surgical intervention, ICU stay, hospital length of stay, and in-hospital mortality.

RESULTS

Prothrombin time was significantly higher in the PPI plus octreotide group (median 19 s vs 11.1 s; p=0.001), and urine output was significantly lower (p=0.011). Despite these differences, there were no significant differences in rebleeding rates, blood product transfusion, ICU stay, mechanical ventilation, or need for surgery. In-hospital mortality was significantly higher in the PPI plus octreotide group (39.3% vs 7%; p=0.011). Hospital length of stay was significantly shorter in the PPI plus octreotide group, likely reflecting higher early mortality rather than improved clinical recovery.

CONCLUSIONS

The addition of octreotide to PPI therapy did not improve bleeding-related outcomes. Prolonged prothrombin time did not correlate with increased bleeding or transfusion needs. These findings suggest no clinical benefit of adjunctive octreotide in this study and underscore the importance of appropriate patient selection.