(P2-84) Upper Gastrointestinal Tract Bleeding (UGIB) Management: Belgian Guidelines for Adults and Children

Background UGIB remains a common disease affecting 100 to 170 adults per year, with an associated mortality ranging from 5 to 14%, causing thereby an important burden to healthcare resources. UGIB in children is uncommon (1–2/10,000 per year) but potentially life threatening. Since various specialists (general practitioners, emergency physicians, gastroenterologists and hepatologists, pediatricians, intensivists, radiologists and surgeons) may be involved and given the absence of evidence-based medical (EBM) recommendations - for adults as well as for children - there is considerable variabili... Mehr ...

Verfasser: Dhondt, E.L.
Penaloza, A.
Colle, I.
Wilmer, A.
Laterre, P.
Dokumenttyp: Artikel
Erscheinungsdatum: 2011
Reihe/Periodikum: Prehospital and Disaster Medicine ; volume 26, issue S1, page s163-s164 ; ISSN 1049-023X 1945-1938
Verlag/Hrsg.: Cambridge University Press (CUP)
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-27304806
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : http://dx.doi.org/10.1017/s1049023x11005292

Background UGIB remains a common disease affecting 100 to 170 adults per year, with an associated mortality ranging from 5 to 14%, causing thereby an important burden to healthcare resources. UGIB in children is uncommon (1–2/10,000 per year) but potentially life threatening. Since various specialists (general practitioners, emergency physicians, gastroenterologists and hepatologists, pediatricians, intensivists, radiologists and surgeons) may be involved and given the absence of evidence-based medical (EBM) recommendations - for adults as well as for children - there is considerable variability in the management of UGIB. Moreover, as even RCTs on the management of UGIB in children are lacking, many treatment strategies are simply deducted from the management of adult UGIB. Aim To provide EBM guidelines for the care of adults and children presenting with bleeding caused by gastro-duodenal ulcer or variceal rupture. Method and Results An interuniversity interdisciplinary team of Belgian experts was launched. Statements based on the published literature up to September 2010 were collected and proposed after expert opinions reconciliation and graded accordingly to the class of evidence. The current guidelines for the management of UGIB include recommendations for the diagnosis process, general supportive care, pharmacological therapy aiming at bleeding control, specific and endoscopic treatment of acute bleeding and follow-up for both gastro-duodenal ulcers and portal hypertension induced bleeding. Specificities and differences in the approach to UGIB in children compared to adults are highlighted. Conclusion Interdisciplinary guidelines for the management of UGIB based on current standards for EBM will provide an opportunity for clinicians to improve the management of their patients. However, clinical guidelines are not mandatory tenets appropriate for all patients, but should constitute a canon or principle tailored to the individual patient. In addition, EBM might provide quality indicators for the assessment of ...