naa a22 4500 510744354 CHVBK 20180411083040.0 cr unu---uuuuu 180411e20130501xx s 000 0 eng 10.1007/s12630-012-9879-1 doi (NATIONALLICENCE)springer-10.1007/s12630-012-9879-1 Mega-dose intravenous octreotide for the treatment of carcinoid crisis: a systematic review [Elektronische Daten] [Nicole Seymour, Sonja Sawh] L'octréotide intraveineux en méga-dose pour le traitement d'une crise carcinoïde: une revue méthodique Purpose: Carcinoid crises are rare life-threatening events involving cardiac instability when carcinoid tumours release vasoactive peptides. Such events can occur in the perioperative setting. Octreotide, a somatostatin analogue, is administered as a bolus dose of 100-500μg iv or by infusion to treat carcinoid crises. Due to the apparent low risk-to-benefit profile, a much higher dose is sometimes used in urgent situations. The purpose of this study was to assess the evidence for administering doses or hourly infusions of octreotide that exceeded 1,500μg iv to treat carcinoid crises. We also sought to identify which patients may require large doses and to describe the adverse effects of such doses. Source: We systematically searched Medline, EMBASE, and Cochrane databases and hand-searched reference lists of relevant articles in 2006 and again in 2010 and 2011. All study designs were included in our search. Resolution of crisis symptoms was the primary outcome. Principal findings: Eighteen articles were included. No patient died during a carcinoid crisis. A retrospective chart review of 89 patients with carcinoid heart disease reported octreotide doses of 25-54,000μg to treat carcinoid crises, although neither crisis symptoms nor outcomes were described. Conclusion: In the included case reports, carcinoid crises were managed effectively using octreotide 25-500μg iv. Previous exposure to octreotide and carcinoid heart disease may warrant the need for higher doses. In addition to the low quality of the articles and the small sample size, inconsistent use of the term "carcinoid crisis” and paucity of reported outcomes were also limitations of this systematic review. These findings highlight the need for further investigation into dose-response relationships of octreotide for the treatment of carcinoid crisis. Canadian Anesthesiologists' Society, 2013 Seymour Nicole School of Pharmacy, University of Waterloo, 10 Victoria St S, N2G 2B2, Kitchener, ON, Canada aut Sawh Sonja London Health Sciences Centre, 339 Windermere Rd, N6A 5A5, London, ON, Canada aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/5(2013-05-01), 492-499 0832-610X 60:5<492 2013 60 12630 https://doi.org/10.1007/s12630-012-9879-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-012-9879-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Seymour Nicole School of Pharmacy, University of Waterloo, 10 Victoria St S, N2G 2B2, Kitchener, ON, Canada aut NATIONALLICENCE 700 1- Sawh Sonja London Health Sciences Centre, 339 Windermere Rd, N6A 5A5, London, ON, Canada aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/5(2013-05-01), 492-499 0832-610X 60:5<492 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer