Vasopressin therapy for upper gastrointestinal tract hemorrhage. Has its efficacy been proven?

Of four reported studies of vasopressin therapy in acute upper gastrointestinal tract hemorrhage, three found vasopressin to be effective and one did not. The studies differed with regard to population, design, and methods. The one study that found vasopressin to be ineffective in controlling gastrointestinal tract hemorrhage may have been better controlled with regard to duration of therapy and evaluation of patients. However, the population studied appeared to be different and the authors may have failed to demonstrate a beneficial effect of vasopressin in a select subgroup of patients. Vasopressin dosing has also been a point of controversy. Hemodynamic data thus far support the use of low-dose infusions. The use of terlipressin (Glypressin), a new analogue of vasopressin, also appears promising.