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Stress induced gastrointestinal bleeding in a pediatric intensive care unit: which risk factors should necessitate

Sanliay Sahin1, Ganime Ayar, Mutlu U Yazici

  • 1Pediatric Intensive Care Unit Ankara Children's Hematology Oncology Education and Research Hospital, Ankara, Turkey - sanliay@yahoo.com.

Minerva Pediatrica
|September 30, 2014
PubMed

Insights

Stress-induced gastrointestinal bleeding (GIB) affects critically ill children. Mechanical ventilation is a key risk factor, and prophylaxis may benefit these patients.

Area of Science:

  • Pediatric Critical Care Medicine
  • Gastroenterology
  • Clinical Research

Background:

  • Stress-induced gastrointestinal bleeding (GIB) is a significant concern in pediatric intensive care units (PICUs).
  • Determining the frequency, risk factors, and prophylactic strategies for GIB in critically ill children is crucial for improving patient outcomes.

Purpose of the Study:

  • To ascertain the incidence and identify risk factors associated with stress-induced GIB in critically ill children.
  • To evaluate the effectiveness of prophylactic interventions in preventing GIB.

Main Methods:

  • A retrospective review of 136 critically ill children admitted to a tertiary care PICU between December 2012 and May 2013.
  • Data collected included diagnoses, demographics, risk factors, prophylaxis use, GIB occurrence, and complications.

Main Results:

  • The overall incidence of GIB was 15.4%.
  • Mechanical ventilation was the only factor significantly associated with stress-induced GIB (P<0.001).
  • Other associated risk factors included trauma, coagulopathy/thrombocytopenia, high PRISM III scores (≥10), renal/hepatic failure, hypotension, and heart failure/arrhythmia (P<0.05).

Conclusions:

  • Gastrointestinal bleeding poses a serious threat to critically ill children in the PICU.
  • Prophylaxis may be beneficial for mechanically ventilated children.
  • Clinicians should remain vigilant for identified risk factors such as trauma, coagulopathy, and organ failure when managing critically ill children.
Abstract

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