BEST EVIDENCE TOPIC REPORT
The use of vasoconstrictor therapy in non-variceal upper GI bleeds
Manchester Royal Infirmary
Report by Gabby May, Senior Clinical Fellow in Emergency Medicine
Checked by John Butler, Consultant in Emergency Medicine and Intensive Care
Manchester Royal Infirmary
| The first 150 words of the full text of this article appear below. |
A short cut review was carried out to establish whether vasoconstrictor therapy is indicated for patients who present with an acute upper gastrointestinal (GI) bleed without known oesophageal varices. In total, 1123 citations were reviewed, of which 16 answered the three part question. The clinical bottom line is that somatostatin (SST) should be considered in unwell patients who are likely to be bleeding secondary to peptic ulcer disease (PUD) until definitive endoscopy, or in situations when endoscopy is contraindicated or unavailable. There is no definitive evidence for the length of time treatment should continue.
[In patients with acute severe non variceal upper GI bleed] is [the use of vasoconstrictor therapy] indicated [to control bleeding and prevent re-bleeding].
A 65 year old man presents to the ED with a large, fresh upper GI bleed. He has a history of non-steroidal anti-inflammatory drug (NSAID) use and complains of increasing indigestion over the
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