Intensive care management of upper gastrointestinal bleeding in children: A review

Managing children having an upper gastrointestinal bleed (UGIB) can be anxiety-provoking for an intensivist, as the differential diagnosis can vary from a benign disorder to a life-threatening condition, with the potential for high fatality if the management is delayed. Common causes in children of...

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Main Authors: Veena Raghunathan, Maninder Singh Dhaliwal, Sakshi Karkra, Abdul Elkadri
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2016-01-01
Series:Journal of Pediatric Critical Care
Subjects:
Online Access:http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2016;volume=3;issue=4;spage=52;epage=62;aulast=Raghunathan
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author Veena Raghunathan
Maninder Singh Dhaliwal
Sakshi Karkra
Abdul Elkadri
author_facet Veena Raghunathan
Maninder Singh Dhaliwal
Sakshi Karkra
Abdul Elkadri
author_sort Veena Raghunathan
collection DOAJ
description Managing children having an upper gastrointestinal bleed (UGIB) can be anxiety-provoking for an intensivist, as the differential diagnosis can vary from a benign disorder to a life-threatening condition, with the potential for high fatality if the management is delayed. Common causes in children of UGIB as a presenting complaint in the emergency department include mucosal lesions and variceal hemorrhage. While in intensive care settings, UGIB is usually secondary and is common in critically sick children with risk factors like respiratory failure, shock, organ failure and trauma. Despite the varied presentation, the primary focus in a child with UGIB is resuscitation and stabilization followed by a diagnostic evaluation. Pharmacological methods in management of UGIB include vitamin K, acid suppression agents while patients with portal hypertension warrant special consideration where splanchnic vasoconstrictors may have a role. Emergency endoscopy in acute UGIB in children can be technically difficult and risky to the patient, and it must be performed only once the patient is adequately stabilized. In this review, an attempt has been made to discuss an intensivist approach to UGIB in children.
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spelling doaj.art-5aef3ee13cea4e6fa6427481fe406de82022-12-22T03:01:50ZengWolters Kluwer Medknow PublicationsJournal of Pediatric Critical Care2349-65922455-70992016-01-0134526210.21304/2016.0304.00145Intensive care management of upper gastrointestinal bleeding in children: A reviewVeena RaghunathanManinder Singh DhaliwalSakshi KarkraAbdul ElkadriManaging children having an upper gastrointestinal bleed (UGIB) can be anxiety-provoking for an intensivist, as the differential diagnosis can vary from a benign disorder to a life-threatening condition, with the potential for high fatality if the management is delayed. Common causes in children of UGIB as a presenting complaint in the emergency department include mucosal lesions and variceal hemorrhage. While in intensive care settings, UGIB is usually secondary and is common in critically sick children with risk factors like respiratory failure, shock, organ failure and trauma. Despite the varied presentation, the primary focus in a child with UGIB is resuscitation and stabilization followed by a diagnostic evaluation. Pharmacological methods in management of UGIB include vitamin K, acid suppression agents while patients with portal hypertension warrant special consideration where splanchnic vasoconstrictors may have a role. Emergency endoscopy in acute UGIB in children can be technically difficult and risky to the patient, and it must be performed only once the patient is adequately stabilized. In this review, an attempt has been made to discuss an intensivist approach to UGIB in children.http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2016;volume=3;issue=4;spage=52;epage=62;aulast=Raghunathanbleedinggastrointestinalpediatricsacuteportal hypertension
spellingShingle Veena Raghunathan
Maninder Singh Dhaliwal
Sakshi Karkra
Abdul Elkadri
Intensive care management of upper gastrointestinal bleeding in children: A review
Journal of Pediatric Critical Care
bleeding
gastrointestinal
pediatrics
acute
portal hypertension
title Intensive care management of upper gastrointestinal bleeding in children: A review
title_full Intensive care management of upper gastrointestinal bleeding in children: A review
title_fullStr Intensive care management of upper gastrointestinal bleeding in children: A review
title_full_unstemmed Intensive care management of upper gastrointestinal bleeding in children: A review
title_short Intensive care management of upper gastrointestinal bleeding in children: A review
title_sort intensive care management of upper gastrointestinal bleeding in children a review
topic bleeding
gastrointestinal
pediatrics
acute
portal hypertension
url http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2016;volume=3;issue=4;spage=52;epage=62;aulast=Raghunathan
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AT sakshikarkra intensivecaremanagementofuppergastrointestinalbleedinginchildrenareview
AT abdulelkadri intensivecaremanagementofuppergastrointestinalbleedinginchildrenareview