Prevalence of stress related GI bleeding in children at a tertiary care hospital
Keywords:
Gastro-Intestinal Bleeding, Endoscopy, PICU, CoagulopathyAbstract
Introduction: Though the upper gastro-intestinal bleeding is relatively uncommon condition in children who are admitted in paediatric intensive care unit (PICU) but it continues to pose a critical challenge in the management. This present study was undertaken to assess the prevalence of gastrointestinal bleeding due to stress and its associated risk factors. Materials and Methodology: All the available medical records of the children who are younger than 15 years admitted to the PICU were retrospectively studied. The basic indications for the in-patient admission comprised of respiratory/cardiovascular failure, shock, coma, post-operative care and patients requiring intensive monitoring. Demographic data, indications for PICU admission and principal diagnosis as well as basic laboratory investigations were recorded. Cross-tabulations were analysed using the chi square test, represented as the odds ratio and 95% confidence interval, in which P < 0.05 was considered statistically significant. Results: A total of 200 charts were eligibly reviewed. There were 89 males (52.4%) with an average age of 3.8 years. The most common indication for PICU admission was respiratory failure (48.8%). GI bleeding complicated 43.5% of cases admitted to the PICU and 5.3% had clinically significant bleeding.
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Chelimsky G,Czinn S. peptic ulcer disease in children. Pediatr Rev 2001;22:349-55.
Lacroix J; Nadeau D; Laberge S; Gauthier M, Lapierre G, Farrell CA et al. Frequency of upper gastrointestinal bleeding in a pediatric intensive care unit. Crit Care Med 1992;20:35-42.
Lopez-Herce J; Dorao P; Elola P; Delgado MA; Ruza F; Madero R . Frequency and prophylaxis of upper gastrointestinal hemorrhage in critically ill children: a prospective study comparing the efficacy of almagate, ranitidine, and sucralfate. The Gastrointestinal Hemorrhage Study Group. Crit Care Med 1992;20:1082-9.
Rodgers, BM. Upper gastrointestinal hemorrhage. Pediatr Rev 1999; 20:171.
Larrosa-Haro A, Coello-Ramírez P. Usefulness of endoscopy in the differential diagnosis of hemorrhage of the upper digestive tract in children. Bol Med Hosp Infant Mex 1992;49:743-9.
Mittal SK, Kalra KK, Aggarwal V. Diagnostic upper GI endoscopy for hematemesis in children: experience from a pediatric gastroenterology centre in north India. Indian J Pediatr 1994;61:651- 4.
Dehghani SM, Haghighat M, Imanieh MH, Tabebordbar MR. Upper gastrointestinal bleeding in children in Southern Iran. Indian J Pediatr 2009;76:635-8.
Schuster DP, Rowley H, Feinstein S, McGue MK, Zuckerman GR. Prospective evaluation of the risk of upper gastrointestinal bleeding after admission to a medical intensive care unit. Am J Med 1984; 76: 623-630.
Cook DJ, Fuller HD, Guyatt GH, Marshall JC, Leasa D, Hall R, Winton TL, Rutledge F, Todd TJ, Roy P. Risk factors for gastrointestinal bleeding in critically ill patients. Canadian Critical Care Trials Group. N Engl J Med 1994; 330: 377-381.
Pimentel M, Roberts DE, Bernstein CN, Hoppensack M, Duerksen DR. Clinically significant gastrointestinal bleeding in critically ill patients in an era of prophylaxis. Am J Gastroenterol 2000; 95: 2801-2806.
Fusamoto H, Hagiwara H, Meren H, Kasahara A, Hayashi N, Kawano S, Sugimoto T, Kamada T. A clinical study of acute gastrointestinal hemorrhage associated with various shock states. Am J Gastroenterol 1991; 86: 429-433.
Chaibou M, Tucci M, Dugas MA, Farrell CA, Proulx F, Lacroix J. Clinically significant upper gastrointestinal bleeding acquired in a pediatric intensive care unit: a prospective study. Pediatrics 1998; 102: 933-938.
Kuusela AL, Mäki M, Ruuska T, Laippala P. Stress-induced gastric findings in critically ill newborn infants: frequency and risk factors. Intensive Care Med 2000; 26: 1501-1506.
Lacroix J, Nadeau D, Laberge S, Gauthier M, Lapierre G, Farrell CA. Frequency of upper gastrointestinal bleeding in a pediatric intensive care unit. Crit Care Med 1992; 20: 35-42.
Harrison AM, Lugo RA, Vernon DD. Gastric pH control in critically ill children receiving intravenous ranitidine. Crit Care Med 1998; 26: 1433-1436.
Lacroix J, Infante-Rivard C, Gauthier M, Rousseau E, van Doesburg N. Upper gastrointestinal tract bleeding acquired in a pediatric intensive care unit: prophylaxis trial with cimetidine. J Pediatr 1986; 108: 1015-1018.
Rinartha, K., Suryasa, W., & Kartika, L. G. S. (2018). Comparative Analysis of String Similarity on Dynamic Query Suggestions. In 2018 Electrical Power, Electronics, Communications, Controls and Informatics Seminar (EECCIS) (pp. 399-404). IEEE.
Kuusela AL, Ruuska T, Karikoski R, Laippala P, Ikonen RS, Janas M, Maki M. A randomized, controlled study of prophylactic ranitidine in preventing stress-induced gastric mucosal lesions in neonatal intensive care unit patients. Crit Care Med 1997; 25: 346-351.
Cook DJ, Reeve BK, Guyatt GH, Heyland DK, Griffith LE, Buckingham L, Tryba M. Stress ulcer prophylaxis in critically ill patients. Resolving discordant meta-analyses. JAMA 1996; 275: 308-314.
Tryba M. Risk of acute stress bleeding and nosocomial pneumonia in ventilated intensive care unit patients: sucralfate versus antacids. Am J Med 1987; 83 :117-124.
Prod’hom G, Leuenberger P, Koerfer J, Blum A, Chiolero R, Schaller MD, Perret C, Spinnler O, Blondel J, Siegrist H, Saghafi L, Blanc D, Francioli P. Nosocomial pneumonia in mechanically ventilated patients receiving antacid, ranitidine, or sucralfate as prophylaxis for stress ulcer. A randomized controlled trial. Ann Intern Med 1994; 120: 653-662.
Lopriore E, Markhorst DG, Gemke RJ. Ventilator-associated pneumonia and upper airway colonisation with Gram negative bacilli: the role of stress ulcer prophylaxis in children. Intensive Care Med 2002; 28: 763-767.
Rakhmonov, O. M., Shadmanov, A. K., & Juraev, F. M. (2021). Results of endoscopic treatment of benign prostatic hyperplasia in patients with metabolic syndrome. International Journal of Health & Medical Sciences, 5(1), 21-25. https://doi.org/10.21744/ijhms.v5n1.1811
Ben-Menachem T, McCarthy BD, Fogel R, Schiffman RM, Patel RV, Zarowitz BJ, Nerenz DR, Bresalier RS. Prophylaxis for stress-related gastrointestinal hemorrhage: a cost effectiveness analysis. Crit Care Med 1996; 24: 338-345.
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