Upper Gastrointestinal Bleeding - The Eastern Association for the Surgery of Trauma

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Eastern Association for the Surgery of Trauma

Upper Gastrointestinal Bleeding

Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding

Lau JYW, Yu Y, Tang RSY, Chan HCH, Yip HC, Chan SC, Luk SWY, Wong SH, Lau LHS, Lui RN, Chan TT, Mak JWY, Chan FKL, Sung JJY.

N Engl J Med. 2020 Apr 2;382(14):1299-1308.

Rationale for Inclusion: A prospective randomized study that demonstrates no improvement in outcomes with upper endoscopy performed within 6 hours of onset of bleeding.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Pantoprazole in Patients at Risk for Gastrointestinal Bleeding in the ICU

Krag M, Marker S, Perner A, et al.

N Engl J Med . 2018 Dec 6;379(23):2199-2208.

Rationale for Inclusion: Blinded randomized trial. Impacts both GI bleeding and critical care domains.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Efficacy of Over-the-Scope Clips in Management of High-Risk Gastrointestinal Bleeding.

Brandler J, Baruah A, Zeb M, Mehfooz A, Pophali P, Wong Kee Song L, AbuDayyeh B, Gostout C, Mara K, Dierkhising R, Buttar N.

Clin Gastroenterol Hepatol. 2018 May;16(5):690-696.e1.

Rationale for Inclusion: Describes the changing epidemiology of gastroitestinal bleed in the United States.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Value of oral proton pump inhibitors in acute, nonvariceal upper gastrointestinal bleeding a network meta-analysis.

Rodriguez EA, Donath E, Waljee AK, Sussman DA.

J Clin Gastroenterol. 2017 Sep;51(8):707-719.

Rationale for Inclusion: Meta-analysis revealing scheduled PO proton pump inhibitors were as effective as IV proton pump inhibitors for most outcomes.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Gastrointestinal safety of celecoxib versus naproxen in patients with cardiothrombotic diseases and arthritis after upper gastrointestinal bleeding (CONCERN): an industry-independent, double-blind, double-dummy, randomised trial.

Chan FKL, Ching JYL, Tse YK, Lam K, Wong GLH, Ng SC, Lee V, Au KWL, Cheong PK, Suen BY, Chan H, Kee KM, Lo A, Wong VWS, Wu JCY, Kyaw MH.

Lancet. 2017 Jun 17;389(10087):2375-2382.

Rationale for Inclusion: Large industry independent study that determines best discharge strategy in patients with GI bleed.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Restrictive versus liberal blood transfusion for acute upper gastrointestinal bleeding (TRIGGER): a pragmatic, open-label, cluster randomised feasibility trial.

Jairath V, Kahan BC, Gray A, Doré CJ, Mora A, James MW, Stanley AJ, Everett SM, Bailey AA, Dallal H, Greenaway J, Le Jeune I, Darwent M, Church N, Reckless I, Hodge R, Dyer C, Meredith S, Llewelyn C, Palmer KR, Logan RF, Travis SP, Walsh TS, Murphy MF.

Lancet. 2015 Jul 11;386(9989):137-44.

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Rationale for inclusion: this large cluster randomized trial confirmed the feasibility and safety of a restrictive transfusion trigger (Hgb <8 g/dL) compared to a more liberal trigger (Hgb <10 g/dL) for upper GI bleeding.

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Transfusion strategies for acute upper gastrointestinal bleeding.

Villanueva C, Colomo A, Bosch A, Concepción M, Hernandez-Gea V, Aracil C, Graupera I, Poca M, Alvarez-Urturi C, Gordillo J, Guarner-Argente C, Santaló M, Muñiz E, Guarner C.

N Engl J Med. 2013 Jan 3;368(1):11-21.

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Rationale for inclusion: this single-center randomized trial demonstrated that a restrictive transfusion strategy (Hgb trigger <7 g/dL) was superior to a more liberal transfusion strategy for upper GI bleeding.

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Meta-analysis: antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding - an updated Cochrane review.

Chavez-Tapia NC, Barrientos-Gutierrez T, Tellez-Avila F, Soares-Weiser K, Mendez-Sanchez N, Gluud C, Uribe M.

Aliment Pharmacol Ther. 2011 Sep;34(5):509-18.

Rationale for inclusion: this meta-analysis confirms that antibiotic prophylaxis for cirrhotic upper GI bleeding is beneficial for bacterial infections, all-cause mortality, rebleeding events, and hospital length of stay.

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Transcatheter arterial embolization versus surgery in the treatment of upper gastrointestinal bleeding after therapeutic endoscopy failure.

Eriksson LG, Ljungdahl M, Sundbom M, Nyman R.

J Vasc Interv Radiol. 2008 Oct;19(10):1413-8.

Rationale for inclusion: this study confirms that after failed endoscopy for upper GI bleeding, arterial embolization should be attempted next before surgical intervention.

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The Canadian Registry on nonvariceal upper gastrointestinal bleeding and endoscopy (RUGBE): endoscopic hemostasis and proton pump inhibition are associated with improved outcomes in a real-life setting.

Barkun A, Sabbah S, Enns R, Armstrong D, Gregor J, Fedorak RN, Rahme E, Toubouti Y, Martel M, Chiba N, Fallone CA; RUGBE Investigators.

Am J Gastroenterol. 2004 Jul;99(7):1238-46.

Rationale for inclusion: this very large registry study confirms the beneficial role of endoscopy and proton pump inhibitor therapy for nonvariceal upper GI bleeding.

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Arterial embolotherapy for upper gastrointestinal hemorrhage: outcome assessment.

Aina R, Oliva VL, Therasse E, Perreault P, Bui BT, Dufresne MP, Soulez G.

J Vasc Interv Radiol. 2001 Feb;12(2):195-200.

Rationale for inclusion: this study confirms the safety and efficacy of arterial embolization for upper GI bleeding.

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Early endoscopy in upper gastrointestinal hemorrhage: associations with recurrent bleeding, surgery, and length of hospital stay.

Cooper GS, Chak A, Way LE, Hammar PJ, Harper DL, Rosenthal GE.

Gastrointest Endosc. 1999 Feb;49(2):145-52.

Rationale for inclusion: this study concludes that early endoscopy for upper GI bleeding is beneficial in terms of hospital length of stay, risk of recurrent bleeding, and need for surgery.

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