Infants with gastrointestinal bleeding

Meta-analysis of studies in adults with acute variceal bleeds found that although vasopressor agents reduced mortality and achieved haemostasis, trials of argipressin were not conclusive and argipressin was less effective for haemostasis compared to octreotide or somatostatin. 12, 13 Argipressin may be used in combination with nitroglycerin so as to balance its vasoconstrictive effect. Major side effects associated with the use of argipressin include myocardial ischaemia, life threatening arrythmias, mesenteric ischaemia and limb vasoconstriction or ischaemia. Other minor complications include water retention with sodium depletion, benign arrhythmia and acrocyanosis. Monitor cardiac rate
and rhythm, and watch for peripheral ischaemia. Terlipressin may be preferred over argipressin as it has the convenience of bolus administration, decreased cardiotoxicity and its ability to control up to 79% of variceal hemorrhage.14,15 (GOR D)
The pharmacology of argipressin in newborns and children has not been sufficiently investigated and data on potential short and long-term adverse effects are still lacking.14,16 Half-life approximately 30 minutes, clinical duration of action 2–3 hours.
References
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