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Upper Gastrointestinal Bleeding

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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.

The use of tranexamic acid for upper gastrointestinal bleeding by medical and surgical intensivists: a single center experience.
Jason Chertoff, Grant Lowther, Hassan Alnuaimat, and Ali Atayaa
Gastroenterology Res. 2017 Aug; 10(4): 235–237.

Rationale for Inclusion: Single center retrospective cohort from 2013-2016 demonstrating that irrespective of outcomes, surgical intensivists utilizie TXA more than medical intensivists inspite literature demonstrating that TXA use in upper gastrointestinal bleeding can reduce rates of needed surgical interventions, rebleeding, and repeat endoscopic interventions.

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.

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.

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

C-reactive protein as a prognostic indicator for rebleeding in patients with nonvariceal upper gastrointestinal bleeding.
Lee HH, Park JM, Lee SW, Kang SH, Lim CH, Cho YK, Lee BI, Lee IS, Kim SW, Choi MG.
Dig Liver Dis. 2015 May;47(5):378-83.

Rationale for Inclusion: Although cholecystectomty is performed as definitive managmenet of gallstone pancreatitis this study utilizing the 2010-2014 National Readmissions database of more than 150,000 admissions for gallstone pancreaitis demonstrated that ERCP was associated with reduced readmissions and support performing ERCP in patients unfit for surgery.

CAVEAT: Single center study.

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

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.

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.

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

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.

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

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.

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

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.

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

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.

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

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.

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

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