Novel Nasogastric Tube-Related Criteria for Urgent Endoscopy in Nonvariceal Upper Gastrointestinal Bleeding

Iwasaki, Hiroyasu; Shimura, Takaya; Yamada, Terumasa; Aoki, Miho; Nomura, Satoshi; Kusakabe, Atsunori; Kanie, Hiroshi; Ban, Tesshin; Hayashi, Katsumi; Joh, Takashi; Orito, Etsuro

doi:10.1007/s10620-013-2706-x

Cited by 12 publications

(11 citation statements)

References 30 publications

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“…Hematemesis, melena, and hematochezia are symptoms that reflect gastrointestinal bleeding . Generally, hematemesis or melena reflects bleeding from the upper gastrointestinal tract and hematochezia reflects bleeding from the lower gastrointestinal tract.…”

Section: Initial Management Of Non‐variceal Upper Gastrointestinal Blmentioning

confidence: 99%

Guidelines for endoscopic management of non‐variceal upper gastrointestinal bleeding

Fujishiro

Iguchi

Kakushima

et al. 2016

Digestive Endoscopy

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Japan Gastroenterological Endoscopy Society (JGES) has compiled a set of guidelines for endoscopic management of non‐variceal upper gastrointestinal bleeding using evidence‐based methods. The major cause of non‐variceal upper gastrointestinal bleeding is peptic gastroduodenal ulcer bleeding. As a result, these guidelines mainly focus on peptic gastroduodenal ulcer bleeding, although bleeding from other causes is also overviewed. From the epidemiological aspect, in recent years in Japan, bleeding from drug‐related ulcers has become predominant in comparison with bleeding from Helicobacter pylori (HP)‐related ulcers, owing to an increase in the aging population and coverage of HP eradication therapy by national health insurance. As for treatment, endoscopic hemostasis, in which there are a variety of methods, is considered to be the first‐line treatment for bleeding from almost all causes. It is very important to precisely evaluate the severity of the patient's condition and stabilize the patient's vital signs with intensive care for successful endoscopic hemostasis. Additionally, use of antisecretory agents is recommended to prevent rebleeding after endoscopic hemostasis, especially for gastroduodenal ulcer bleeding. Eighteen statements with evidence and recommendation levels have been made by the JGES committee of these guidelines according to evidence obtained from clinical research studies. However, some of the statements that are supported by a low level of evidence must be confirmed by further clinical research.

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Section: Initial Management Of Non‐variceal Upper Gastrointestinal Blmentioning

confidence: 99%

Guidelines for endoscopic management of non‐variceal upper gastrointestinal bleeding

Fujishiro

Iguchi

Kakushima

et al. 2016

Digestive Endoscopy

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“…4,8 Up to 18% of patients with upper GI bleeding have nonbloody aspirate. 4,8 Up to 18% of patients with upper GI bleeding have nonbloody aspirate.…”

Section: Laboratory Evaluationmentioning

confidence: 99%

“…Studies reveal that a PPI bolus followed by a continuous infusion for 72 hours is more effective than bolus alone in decreasing the incidence of rebleeding and need for surgery. 4,8 Patients with NSAID-induced upper GI bleeding should discontinue their NSAID and be administered PPI therapy. 4 After EGD, patients determined to be low risk can be discharged on oral PPIs.…”

Section: Treatment and Follow-upmentioning

confidence: 99%

“…8 Discontinuation of aspirin is associated with a threefold increased risk of a major cardiovascular event and signifi cantly higher mortality at 8 weeks; immediately restarting aspirin in combination with a PPI results in a twofold increase in the risk of rebleeding. 8 Discontinuation of aspirin is associated with a threefold increased risk of a major cardiovascular event and signifi cantly higher mortality at 8 weeks; immediately restarting aspirin in combination with a PPI results in a twofold increase in the risk of rebleeding.…”

Section: Treatment and Follow-upmentioning

confidence: 99%

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Assessing upper gastrointestinal bleeding in adults

Pezzulo

Kruger

2014

Journal of the American Academy of Physician Assistants

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“…However, the indiscriminate use of NGT has been questioned, as it is one of the most painful procedures performed at the emergency department and its benefits in reducing mortality, surgery, need of blood transfusion, and length of hospitalization have not been consistently reported (16)(17)(18). Iwasaki et al suggested that a fresh or dark red fluid from NGT associated with a high heart rate/systolic blood pressure ratio could be used to predict active bleeding and the need of urgent endoscopy in patients with nonvariceal UGIB (19), but until further benefits in clinical outcomes are confirmed, no recommendation for its extended use can be made.…”

Section: Resuscitation and General Managementmentioning

confidence: 99%

New insights on an old medical emergency: non-portal hypertension related upper gastrointestinal bleeding

Cúrdia-Gonçalves¹,

Rosa²,

Cotter³

2016

Rev Esp Enferm Dig

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Upper gastrointestinal bleeding (UGIB) is a potentially life-threatening condition and the most common medical emergency managed by gastroenterologists. Despite being one of the most antique medical problems, recent studies have been slowly changing the management of these patients, which should nowadays include not only initial resuscitation, but also risk stratification, pre-endoscopic therapy, endoscopy treatment, and post-procedure care. The aim of this paper is to review the extended approach to the patient with non-portal hypertension related UGIB.

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Novel Nasogastric Tube-Related Criteria for Urgent Endoscopy in Nonvariceal Upper Gastrointestinal Bleeding

Abstract: A novel and simple criteria system using NGT(+) and HR/SBP is a good predictor of the need for urgent endoscopy in patients with nonvariceal UGIB.

Cited by 12 publications

References 30 publications

Guidelines for endoscopic management of non‐variceal upper gastrointestinal bleeding

Guidelines for endoscopic management of non‐variceal upper gastrointestinal bleeding

Assessing upper gastrointestinal bleeding in adults

New insights on an old medical emergency: non-portal hypertension related upper gastrointestinal bleeding

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