Bleeding Ulcer Guidelines May Be Revised
Researchers at the Yale University School of Medicine concluded that the current standard of care for managing patients who receive endoscopic treatment for bleeding ulcers should be replaced by an equally safe and less expensive alternative that is more comfortable for patients, as presented at Digestive Disease Week in Chicago, IL.
The current recommended care plan consists of an initial dose of a proton pump inhibitor (PPI) followed by continuous PPI infusion for 72 hours as maintenance. Study authors compared this regimen to that of one using only intermittent PPI therapy where patients are given a dose of PPI either orally or through an IV line at set intervals.
Hamita Sachar, MD, lead study researcher and senior digestive diseases fellow at Yale School of Medicine, and colleagues reviewed 13 trials evaluating patients (n=1,691)who received successful endoscopic therapy for management of high-risk findings in bleeding ulcers. The use of intermittent PPI resulted in a similar likelihood of re-bleeding, death, need for urgent interventions such as surgery, more blood transfusions or an increased length of hospital stay. This new approach does not require patients to be connected to infusion equipment, which reduces the need for pharmacy and nursing oversight.
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