Friday, April 10, 2009

Friday April 10, 2009 (pediatric pearl)
Risk factors of upper gastrointestinal bleeding in mechanically ventilated children


Overt upper gastrointestinal bleeding* is common of critically ill children requiring mechanical ventilation (52%).

Significant upper gastrointestinal bleeding*1 is uncommon (3.6%) (Similar to that seen in adults studies).

60% of patients with UGI bleeding occurred on the first day and more than 90% occurred within the first 3 days.

*Overt upper gastrointestinal bleeding = evidence of hematemesis, gross blood, or “coffee ground” material in nasogastric aspirates, hematochezia, or melena

*1 Significant UGI bleeding = defined as a spontaneous decrease of more than 20 mm Hg in the systolic blood pressure, an increase of more than 20 beats per minute in the heart rate, a decrease in the hemoglobin level of more than 2 g/dL, the receipt of packed red blood cell transfusion and gastric or duodenal surgery.




Reference: click to get abstract

Incidence and risk factors of upper gastrointestinal bleeding in mechanically ventilated children - Pediatric Critical Care Medicine. 10(1):91-95, January 2009