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Showing 2 results for Gastrointestinal Bleeding

Kambiz Eftekhari, Armen Malekiantaghi, Neda Habibi ,
Volume 80, Issue 9 (12-2022)
Abstract

Background: Gastrointestinal bleeding (GIB) associated with stress is an important complication in critically ill children admitted to the Intensive care unit (ICU), which can lead to serious complications and in some cases death. Only a limited number of studies have been conducted on the risk factors of gastrointestinal bleeding in Pediatric Intensive care unit (PICU), most studies have been conducted in the adults and neonates, therefore, the aim of this study was to evaluate the frequency of risk factors related to gastrointestinal bleeding in children admitted to the PICU.
Methods: This was a cross-sectional study. In this study, in a period of three years from (March 2016 to March 2019), all patients admitted to the PICU of Tehran Bahrami Children's Hospital were examined. The sample size was calculated 380. Demographic information, diagnosis during hospitalization, underlying disease, and initial tests during the first 24 hours of hospitalization were recorded in the checklist. To evaluate the demographic findings between patients with and without UGIB, chi-square and Fisher tests were used. A p-value of less than 0.05 was considered significant.
Results: 462 patients were studied, of which about (58%) were male. The mean age of the samples was 48 months and the average length of hospital stay in PICU was ten days. In general, (21.21%) of patients had gastrointestinal bleeding on the first day and (12.12%) on the second day of hospitalization. Gastrointestinal bleeding occurred in 50 patients (10.82%). Use of ventilator, pulmonary diseases, coagulation and blood diseases were significantly more common in patients with gastrointestinal bleeding than in children without gastrointestinal bleeding. Cardiac, neurological, hepatic, and renal disease were not significantly different in patients with gastrointestinal bleeding compared to children without gastrointestinal bleeding.
Conclusion: The occurrence of gastrointestinal bleeding in critically ill patients admitted to the PICU is a serious risk. The most important risk factor for upper gastrointestinal bleeding is mechanical ventilation. Other risk factors of gastrointestinal bleeding are lung disease, coagulation diseases, hematologic and oncologic disease.

Seyed Arash Yazdanbakhsh, Simin Najafgholian, Arash Izadpanah , Mohammad Parohan, Azim Forozan, Amir Almasi Heshiani ,
Volume 81, Issue 11 (2-2024)
Abstract

Background: Acute gastrointestinal bleeding is one of the critical emergencies with good prognosis if properly managed. Combination of drug has had the best possible clinical results to stabilize the hemodynamic status of these patients. Therefore, in this study, the short-term consequences of simultaneous administration of vasopressin and tranexamic acid were compared.
Methods: In this double-blind clinical trial study that was conducted from November 2018 to November 2019 at Valiasr Hospital in Arak 120 eligible patients with acute gastrointestinal bleeding were included. Patients were divided into four groups of 30. In the first group (TXA) the common treatment with tranexamic acid was first infused at the rate of 10mg/kg as an initial dose over 20 minutes and then received to 1mg/kg per hour as a maintenance dose for up to four hours. The second group (VP group) received common treatment with infusion of 30 units per hour for six hours. The third group (R group) received only conventional treatments and the fourth group (TXA+VP group) received both tranexamic acid and vasopressin along with conventional treatment. The amount of light blood lose and vital signs including blood pressure and heart rate and Hg, BUN , CR , NA, K, BS, PT, PTT, INR were checked.
Results: In this study, the vasopressin group had a greater decrease in hemoglobin (p≤0.05), the increase in blood urea was less in the two groups that received vasopressin than the other two groups (p≤0.05). The group of tranexamic acid had much better conditions than the group of vasopressin, in terms of hematochezia or hematemesis interruption, need for blood transfusion, re-bleeding, need for endoscopy and emergency surgery, and adding vasopressin to tranexamic acid also led to improved outcomes (p≤0.05).
Conclusion: It seems that the concurrent use of tranexamic acid and vasopressin in upper gastrointestinal bleeding improves renal function and stops bleeding and reduces the risk of re-bleeding, the need for blood transfusion and endoscopic and surgical intervention. Its long-term results need further study.


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