LOXYTOCINE: ALTERNATIVE THERAPEUTIQUE DANS LES HEMORRAGIES DIGESTIVES HAUTES VARIQUEUSES A ANTANANARIVO (MADAGASCAR)?

Aim: The aim of the study is to assess the effect of oxytocin on the hemodynamic status of patients with variceal upper digestive hemorrhage becausethe main principle of the management of this pathology is hemodynamic optimization through vasoconstrictors (octreotide, somatostatin, ...), that are not available in Madagascar.

Materials and Methods: A descriptive and monocentric, retrospective study was carried out in University Hospital J. R. Andrianavalona, for a period of 60 months (2010 to 2014).Patients with known variceal upper gastrointestinal bleeding were included. Correlations (Chi² or exact Fishers test, XLStat^®10.0) between oxytocin use and hemodynamic parameters, therapeutics and mortality were performed.

Results: A number of 175 patients aged 47.5 ± 13.6 years, predominantly male (sex ratio = 2.4) were studied. The admission pattern was dominated by the combination of hematemesis and melena (52.6%). The use of oxytocin had an impact on the decrease of hemodynamic parameters (p <0.05). This molecule limited perfusion and blood transfusion (p <0.001). The use of oxytocin had no impact on patient survival and death (18.3%) (p> 0.05).

Conclusion: Because of the lack of main vasoactive drugs, oxytocin could be an alternative to vasoactive treatment in Antananarivo (Madagascar), without specific impact on the morbidity and mortality of upper gastrointestinal varicose bleedings.