Prevalence of, and risk factors for, upper gastrointestinal tract bleeding in critically ill pediatric patients

E. B. Cochran, Stephanie Phelps, Elizabeth Tolley, G. L. Stidham

Research output: Contribution to journalArticle

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Abstract

Objective: To determine the occurrence of, and risk factors for, the development of upper gastrointestinal (GI) tract bleeding in critically ill pediatric patients. Design: Prospective, descriptive, comparative study. Setting: ICU in a tertiary care pediatric hospital affiliated with a university. Patients: All patients <19 yrs of age who were admitted to the ICU for a 4-month period (n = 429) were eligible for inclusion. A total of 221 patients were excluded for reasons listed below. Thus, 208 patients were studied. Intervention: None. Measurements and Main Results: Patients were evaluated for overt upper GI bleeding as indicated by coffee ground material or bright red blood in gastric aspirates or black, tarry stools. Excluded were patients who were transferred out of the ICU within 24 hrs of admission, were receiving medications that would alter their risk for upper GI bleeding, or had a GI tract surgical procedure. Patients were categorized by diagnoses and analyzed for relative risk for upper GI bleeding. Of the 208 patients included, 25% had evidence of upper GI bleeding. There was no association between upper GI bleeding and age, weight, race, or sex. Diagnoses independently associated with an increased risk for upper GI bleeding were: circulatory shock, an operative procedure ≥3 hrs in duration, and trauma. No clinically important sequelae were directly attributable to upper GI bleeding in this group of patients; however, intervention with antacids and histamine- 2 receptor (H-2) antagonists likely decreased the progression of GI bleeding. Conclusions: Overt evidence of upper GI bleeding is not uncommon in critically ill pediatric patients. Certain diagnoses or risk factors may predispose these patients to develop upper GI bleeding.

Original languageEnglish (US)
Pages (from-to)1519-1523
Number of pages5
JournalCritical Care Medicine
Volume20
Issue number11
DOIs
StatePublished - Jan 1 1992

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Upper Gastrointestinal Tract
Critical Illness
Pediatrics
Hemorrhage
Digestive System Surgical Procedures
Histamine Receptors
Antacids
Pediatric Hospitals
Coffee
Operative Surgical Procedures
Tertiary Healthcare
Gastrointestinal Tract
Shock
Stomach

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

Prevalence of, and risk factors for, upper gastrointestinal tract bleeding in critically ill pediatric patients. / Cochran, E. B.; Phelps, Stephanie; Tolley, Elizabeth; Stidham, G. L.

In: Critical Care Medicine, Vol. 20, No. 11, 01.01.1992, p. 1519-1523.

Research output: Contribution to journalArticle

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