Endoscopic hemostasis in intensive care unit patients with upper digestive tract bleeding

Abstract

Introduction: Patients hospitalized in an intensive care unit (ICU) are at risk of upper gastrointestinal bleeding. Esophagogastroduodenoscopy (EGD) is the test of choice for these patients. EGD is diagnostic and therapeutic. Many endoscopically identified lesions do not require endoscopic treatment. In Colombia there are no studies on the prevalence of different upper gastrointestinal bleeding lesions in ICU patients, nor on the use of therapeutic EGD in these patients. Materials and methods: This is a cross-sectional study conducted at the Clínica Fundadores in Bogotá Colombia between January 2003 and February 2017. Adult ICU patients who underwent EGD due to upper gastrointestinal bleeding were included. Results: In the final analysis, 156 patients who underwent EGD were included. Of these, 76.62% (118) had chronic gastritis, 57.79% (89) had erosive esophagitis grades A to D, 47.4% (73) had erosive gastritis, 21.43% (33) had erosive duodeni-tis, 18.18% (28) had gastric ulcer, 11.69% (18) had esophageal varices, 11.04% (17) had duodenal ulcers, and 4.55% (8) Mallory Weiss tears. Only 15% of patients, including those with esophageal varices, required endoscopic management. Conclusions: In this study, 15% of patients with upper gastrointestinal bleeding required endoscopic treatment. Prospective work should be done to establish risk factors to predict the need for therapeutic EGD in patients with upper gastrointestinal bleeding. Patients do not have these predictors should be treated empirically with PPI to avoid unnecessary expenses of diagnostic EGDs.