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Published on: September 22, 2023
[Risk for the development of upper gastrointestinal bleeding in children in an intensive care unit]
Glenda Karina Gutiérrez-Gutiérrez1, Miguel Angel Villasís-Keever, Beatriz González-Ortiz
1Servicio de Gastroenterología Pediátrica, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México. miguel.villasis@imss.gob.mx.
Insights
Upper gastrointestinal bleeding is common in pediatric intensive care units. Key risk factors include prolonged clotting times, thrombocytopenia, sepsis, and pneumonia, highlighting the need for targeted interventions.
Area of Science:
- Pediatric critical care medicine
- Gastroenterology
- Epidemiology
Background:
Although gastrointestinal tract bleeding can occur at any age, most studies trying to establish causes or risk factors for its development have been conducted in adults. The aim of this study was to determine risk factors in children admitted in a pediatric intensive care unit.
Methods:
A retrospective case-control study was conducted. Children who developed upper gastrointestinal bleeding children during their stay at the intensive care unit were considered the cases. Variables were obtained from medical records including age, sex, nutritional status, mechanical ventilation, use of nasogastric tube, development of complications, presence of coagulopathy, use of prophylaxis for upper gastrointestinal tract bleeding, fasting and use of steroids. Using a multivariate analysis, risk factors were identified, with odds ratios (OR) and 95 % confidence intervals (95 % CI) calculations.
Results:
Out of 165 patients, 58 had upper gastrointestinal bleeding (35 %). Risk factors identified were prolonged clotting times (OR = 3.35), thrombocytopenia (OR = 2.39), development of sepsis (OR = 6.74) or pneumonia (OR = 4.37). Prophylaxis for upper gastrointestinal bleeding was not a protective factor.
Conclusions:
Upper gastrointestinal bleeding frequency in children hospitalized in an intensive care unit was high. Identifying risk factors should help to reduce upper gastrointestinal bleeding frequency.
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