rgent versus elective colonoscopy in acute lower gastrointestinal bleeding: a randomized controlled trial - Urgent versus elective colonoscopy in acute hematochezia

Medisch Centrum Haaglanden0 个研究点目标入组 132 人开始时间: 待定最近更新: 2024年4月29日

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•All adults aged 18 years or older, presenting with acute hematochezia in the emergency department are included when:
•- able to provide written informed consent
•- the last bloody bowel movement is within 24 hours of presentation
•- an upper gastro-intestinal bleeding source is not suspected or excluded by upper endoscopy;Criteria for suspicion of an upper source are:
•- blood urea > 10% of creatinin value
•- collapse
•- hemodynamic instability (one of the following high risk features present):
•* heart rate > 100 beats/min
•* systolic blood pressure < 100 mmHg
•* orthostatic changes in systolic blood pressure >20 mmHg or in heart rate >20 beats/min
•* blood transfusion or drop in haemoglobin >1 mmol/l within a 6 hour period

•Patients are excluded when:
•- age < 18 years
•- unable to provide written informed consent
•- known or suspected acute ischemic bowel, perforation or peritonitis
•- hemodynamic instability refractory to resuscitation
•- coagulopathy refractory to correction
•- documented pregnancy
•- serious comorbidities that would preclude to use of colonoscopy in standard clinical practice (i.e. severe COPD, severe cardiovasculair comorbidity)
•- decreased level of consiousness

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