Continuous infusion of high-dose omeprazole is more effective than standard-dose omeprazole in patients with high-risk peptic ulcer bleeding: a retrospective study

Peptic ulcer bleeding is a common medical emergency and still a potentially fatal condition. It is the best managed using a multidisciplinary approach by a team with medical, endoscopic and surgical expertise. Appropriate resuscitation followed by early endoscopy for diagnosis and treatment are of major importance in these patients. Endoscopy is recommended within 24 h of presentation. Endoscopic therapy is indicated for patients with high-risk stigmata, in particular those with active bleeding and visible vessels. A combination of proton pump inhibitors and endoscopic therapy (using a combination of injection and mechanical hemostasis) offers the best chance of hemostasis for those with active bleeding ulcers. The application of an ulcer-covering hemospray is a new promising tool. High dose proton pump inhibitors should be administered intravenously for 72 h in high-risk patients. Helicobacter pylori should be tested for in all patients with peptic ulcer bleeding and eradicated if positive

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High-Dose Pantoprazole Continuous Infusion Is Superior to Somatostatin After Endoscopic Hemostasis in Patients With Peptic Ulcer Bleeding

The American Journal of Gastroenterology ◽

10.1111/j.1572-0241.2007.01120.x ◽

2007 ◽

Vol 102 (6) ◽

pp. 1192-1199 ◽

Cited By ~ 16

Author(s):

Panagiotis Tsibouris ◽

Elias Zintzaras ◽

Christos Lappas ◽

Maria Moussia ◽

George Tsianos ◽

...

Keyword(s):

Peptic Ulcer ◽

Continuous Infusion ◽

Endoscopic Hemostasis ◽

Ulcer Bleeding ◽

High Dose ◽

Peptic Ulcer Bleeding

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A Real World Report on Intravenous High-Dose and Non-High-Dose Proton-Pump Inhibitors Therapy in Patients with Endoscopically Treated High-Risk Peptic Ulcer Bleeding

Gastroenterology Research and Practice ◽

10.1155/2012/858612 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 6

Author(s):

Lung-Sheng Lu ◽

Sheng-Chieh Lin ◽

Chung-Mou Kuo ◽

Wei-Chen Tai ◽

Po-Lin Tseng ◽

...

Keyword(s):

Peptic Ulcer ◽

High Risk ◽

Proton Pump ◽

Real World ◽

Case Control ◽

Ulcer Bleeding ◽

Control Group ◽

High Dose ◽

Peptic Ulcer Bleeding ◽

Treatment Control

Background and Study Aims. The optimal dose of intravenous proton-pump inhibitor (PPI) therapy for the prevention of peptic ulcer (PU) rebleeding remains controversial. This study aimed to understand the real world experiences in prescribing high-dose PPI and non-high-dose PPI for preventing rebleeding after endoscopic treatment of high-risk PU.Patients and Methods. A total of 220 subjects who received high-dose and non-high-dose pantoprazole for confirmed acute PU bleeding that were successfully treated endoscopically were enrolled. They were divided into rebleeding (n=177) and non-rebleeding groups (n=43). Randomized matching of the treatment-control group was performed. Patients were randomly selected for non-high-dose and high-dose PPI groups (n=44in each group).Results. Univariate analysis showed, significant variables related to rebleeding were female, higher creatinine levels, and higher Rockall scores (≧6). Before case-control matching, the high-dose PPI group had higher creatinine level, higher percentage of shock at presentation, and higher Rockall scores. After randomized treatment-control matching, no statistical differences were observed for rebleeding rates between the high-dose and non-high-dose groups after case-control matching.Conclusion. This study suggests that intravenous high-dose pantoprazole may not be superior to non-high-dose regimen in reducing rebleeding in high-risk peptic ulcer bleeding after successful endoscopic therapy.

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347n: A Retrospective Study Comparing the Results of Argon Plasma Coagulation Versus Bipolar Probe Coaptation As a Treatment for High Risk Peptic Ulcer Bleeding

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2010.03.036 ◽

2010 ◽

Vol 71 (5) ◽

pp. AB113 ◽

Cited By ~ 1

Author(s):

Salyavit Chittmittrapap ◽

Danai Limmathurotsakul ◽

Rungsun Rerknimitr ◽

Wiriyaporn Ridtitid ◽

Pradermchai Kongkam ◽

...

Keyword(s):

Peptic Ulcer ◽

Retrospective Study ◽

High Risk ◽

Argon Plasma Coagulation ◽

Argon Plasma ◽

Ulcer Bleeding ◽

Peptic Ulcer Bleeding ◽

Plasma Coagulation

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EFFICACY OF INITIAL AND PERMANENT HEMOSTASIS OF THE ENDOSCOPIC HEMOCLIP METHOD COMBINED WITH HIGH-DOSE INFUSION OF PROTON PUMP INHIBITOR IN PATIENTS WITH PEPTIC ULER BLEEDING

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.2.2 ◽

2018 ◽

pp. 15-21

Author(s):

Hieu Tam Huynh ◽

Dang Quy Dung Ho

Keyword(s):

Peptic Ulcer ◽

Success Rate ◽

Endoscopic Hemostasis ◽

Ulcer Bleeding ◽

Injection Sclerotherapy ◽

High Dose ◽

Peptic Ulcers ◽

Peptic Ulcer Bleeding ◽

Bleeding Peptic Ulcers ◽

Hemostatic Therapy

Background: Peptic ulcer bleeding is one of the common medical emergencies. The hemostatic efficacy of endoscopic therapeutic modalities has been reported in many studies and frequently has been found to exceed 90%. Four groups of modalities are used in the endoscopic management of bleeding peptic ulcers: thermal probe methods, injection sclerotherapy, local spray methods, and mechanical hemostatic therapy. The endoscopic hemoclip method is a safe and effective hemostatic therapy for managing bleeding peptic ulcers. Objective: To determine the success rate of hemoclip in endoscopic hemostasis. Patients and methods: Clinical intervention study on 36 patients with peptic ulcer bleeding admitted in Can Tho Central General Hospital from May 2012 to November 2014. All the patients underwent emergency endoscopy for hemostasis by hemoclip and high-dose PPI use. Results: The success rate of initial hemostasis was 97.2%, and permanent hemostasis was 91.7%. The rates of rebleeding, surgery, mortality were 11.1%, 5.6%, 2.8%, respectively. Conclusion: Endoscopic hemostasis therapy by clipping combined with high- dose PPI is an effective, relatively safe treatment for peptic ulcer bleeding. Key words: Peptic ulcer bleeding, hemoclip, endoscopic hemostasis therapy

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