Upper gastrointestinal tract hemorrhage (UGIH) remains a major cause of morbidity and mortality . Nasogastric aspiration (NGA) is routinely performed in patients with UGIH to obtain important clinical data and make therapeutic decisions. But routine use of NGA remains controversial with studies reporting its usefulness and its redundant clinical information. Early esophagogastroduodenoscopy (EGD) is recommended by most gastrointestinal societies to allow for risk stratification and to perform endoscopic treatments. The results of the NGA may assist to differentiate between high-risk versus low-risk lesions. Our hypothesis is that presence of NGA can identify lesions that require endoscopic treatment and provides important clinical information to guide the treating physician. In addition, we hypothesized that the results of the NGA influence the clinical decision of the treating physician regarding the prediction of the need for endoscopic therapy. This observational randomized cross-sectional study will enroll consecutive patients with presumed UGIH and randomized them to NGA and no NGA recording its results. All patients will receive an EGD and its results will also be recorded. Subsequently, we will evaluate if the NGA is important in identifying endoscopically significant lesions. The information gained will help guide clinicians evaluating patient with UGIH.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
282
standard nasogastric tube placement, aspiration and lavage up to 1L of normal saline
Parkland Memorial Hospital
Dallas, Texas, United States
The number of patients predicted accurately to have a treatable lesion
Time frame: 24h
Complications of nasogastric aspiration and lavage
Time frame: 24h
Relationship between time to endoscopy and upper gastrointestinal hemorrhage
Time frame: 24h
Relationship of nasogastric aspirate and lavage with number of units of packed reb blood cells transfused
Time frame: 24h
Complication of nasogastric tube placement and aspiration in cirrhotics
Time frame: 24h
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