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Postgraduate Education Corner: Contemporary Reviews in Critical Care Medicine |

Octreotide56Use of Somatostatin Analogues in the ICU: A Drug Often Used in the Critical Care Setting but Not Well Understood

Mallory M. Chan, BA; Michael M. Chan, BS; John Andrew Mengshol, MD, PhD; Douglas N. Fish, PharmD; Edward D. Chan, MD
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From the University of Colorado School of Medicine (Ms Chan), Denver; University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences (Mr Chan and Dr Fish), Division of Gastroenterology (Dr Mengshol), Division of Pulmonary Sciences and Critical Care Medicine (Dr Chan), University of Colorado Anschutz Medical Campus, Aurora; Department of Medicine (Drs Mengshol and Chan), Denver Veterans Affairs Medical Center, Denver; and the Departments of Medicine and Academic Affairs (Dr Chan), National Jewish Health, Denver, CO.

Correspondence to: Edward D. Chan, MD, D509, Neustadt Bldg, National Jewish Health, 1400 Jackson St, Denver, CO 80206; e-mail: chane@njhealth.org


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(6):1937-1945. doi:10.1378/chest.13-0382
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While the canonical function of somatostatin (SST) is to inhibit the secretion of growth hormone, it has a number of other physiologic effects that are less widely appreciated. Octreotide, an analog of SST, is not uncommonly used in the critical care setting, particularly for the treatment of variceal hemorrhage. Herein, we discuss the biology and pharmacology of SST, octreotide, and other SST analogs. We also review the evidence behind their use in esophageal variceal bleeds, hepatorenal syndrome, hypoglycemia due to sulfonylurea poisoning, and chylous pleural effusions.

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