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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(12): E1811-E1816
DOI: 10.1055/a-1266-3501
Original article

Novel upper gastrointestinal monitoring system to track upper gastrointestinal bleeding: A pilot study

Chiao-Hsiung Chuang
1   Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
2   Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
,
Chien-Cheng Chen
2   Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
,
Jhong-Han Wu
1   Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
,
Ming-Yuan Hong
3   Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
,
Jui-Wen Kang
1   Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
,
Hsin-Yu Kuo
1   Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
,
Chien-Jui Huang
1   Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
,
Chiung-Yu Chen
1   Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Abstract

Background and study aims Early detection of upper gastrointestinal (UGI) rebleeding is not easy by observing clinical symptoms. We developed a novel UGI monitoring system and aimed to test its feasibility of continuous tracking of UGI bleeding.

Patients and methods A prospective study was conducted on patients with moderate to high risk of rebleeding. The UGI monitoring system was installed to monitor their gastric contents. It would alarm if rebleeding was suspected and the physician could review the images to make a further decision. The patient’s comfort level was also evaluated.

Results Sixteen patients were enrolled. Rebleeding occurred in one patient and was detected by this system more than 5 hours earlier than with clinical symptoms. The interobserver reliability for reviewing the images to define the blood clearance in the stomach was excellent (intraclass correlation coefficient 0.79–0.96). The comfort level assessed by patients was 1.90 ± 1.39 (on the scale of 0–5).

Conclusions This pilot study demonstrated the potential of this UGI monitoring system for early detection of rebleeding.



Publication History

Received: 07 June 2020

Accepted: 20 August 2020

Article published online:
17 November 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Louis HSL, Sung JJ. Treatment of UGI bleeding in 2020: new techniques and outcomes. Dig Endosc 2020; DOI: 10.1111/den.13674.
    CrossrefPubMedGoogle Scholar
  • 2 Sengupta N, Tapper EB, Patwardhan VR. et al. High Glasgow Blatchford Score at admission is associated with recurrent bleeding after discharge for patients hospitalized with upper gastrointestinal bleeding. Endoscopy 2016; 48: 9-15
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Barkun AN, Bardou M, Kuipers EJ. et al. International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med 2010; 152: 101-113
    CrossrefPubMedGoogle Scholar
  • 4 Mangiafico S, Pigò F, Bertani H. et al. Over-the-scope clip vs epinephrine with clip for first-line hemostasis in non-variceal upper gastrointestinal bleeding: a propensity score match analysis. Endosc Int Open 2020; 8: E50-E58
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Nam JH, Jeon TJ, Cho JH. et al. Risk factors of the rebleeding according to the patterns of nonvariceal upper gastrointestinal bleeding. Turk J Gastroenterol 2017; 28: 266-271
    CrossrefPubMedGoogle Scholar
  • 6 Maggio D, Barkun AN, Martel M. et al. Reason Investigators. Predictors of early rebleeding after endoscopic therapy in patients with nonvariceal upper gastrointestinal bleeding secondary to high-risk lesions. Can J Gastroenterol 2013; 27: 454-458
    CrossrefPubMedGoogle Scholar
  • 7 Sheibani S, Kim JJ, Chen B. et al. Natural history of acute upper GI bleeding due to tumors: short‐term success and long‐term recurrence with or without endoscopic therapy. Aliment Pharmacol Ther 2013; 38: 144-150
    CrossrefPubMedGoogle Scholar
  • 8 Hong MJ, Lee SY, Kim JH. et al. Rebleeding after initial endoscopic hemostasis in peptic ulcer disease. J Korean Med Sci 2014; 29: 1411-1415
    CrossrefPubMedGoogle Scholar
  • 9 Cheng HC, Yang EH, Wu CT. et al. Hypoalbuminemia is a predictor of mortality and rebleeding in peptic ulcer bleeding under proton pump inhibitor Use. J Formos Med Assoc 2018; 117: 316-325
    CrossrefPubMedGoogle Scholar
  • 10 Sung JJ, Barkun A, Kuipers EJ. et al. Intravenous esomeprazole for prevention of recurrent peptic ulcer bleeding: a randomized trial. Ann Intern Med 2009; 150: 455-464
    CrossrefPubMedGoogle Scholar
  • 11 Laine L, Jensen DM. Management of patients with ulcer bleeding. Am J Gastroenterol 2012; 107: 345-361
    CrossrefPubMedGoogle Scholar
  • 12 Lau JYW, Yu Y, Tang RSY. et al. Timing of endoscopy for acute upper gastrointestinal bleeding. N Engl J Med 2020; 382: 1299-1308
    CrossrefPubMedGoogle Scholar
  • 13 Singer AJ, Richman PB, Kowalska A. et al. Comparison of patient and practitioner assessments of pain from commonly performed emergency department procedures. Ann Emerg Med 1999; 33: 652-658
    PubMedGoogle Scholar
  • 14 Musser J, Kelchner L, Neils-Strunjas J. et al. Patient Compliance during 24-Hour Dual pH Probe Monitoring for Extraesophageal Reflux. ISRN Otolaryngol 2011; 703936
    PubMedGoogle Scholar
  • 15 Sung JJ, Tang RS, Ching JY. et al. Use of capsule endoscopy in the emergency department as a triage of patients with GI bleeding. Gastrointest Endosc 2016; 84: 907-913
    CrossrefPubMedGoogle Scholar
  • 16 Shah N, Chen C, Montano N. et al. Video capsule endoscopy for upper gastrointestinal hemorrhage in the emergency department: A systematic review and meta-analysis. Am J Emerg Med 2020; 38: 1245-1252
    CrossrefPubMedGoogle Scholar
  • 17 Schmidt A, Zimmermann M, Bauder M. et al. Novel telemetric sensor capsule for EGD urgency triage: a feasibility study. Endosc Int Open 2019; 7: E774-E781
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Ogasawara N, Mizuno M, Masui R. et al. Predictive factors for intractability to endoscopic hemostasis in the treatment of bleeding gastroduodenal peptic ulcers in Japanese patients. Clin Endosc 2014; 47: 162-173
    CrossrefPubMedGoogle Scholar