Impact of nasogastric lavage on outcomes in acute GI bleeding

Is nasogastric tube lavage in patients with acute upper GI bleeding indicated or antiquated?

“…6 In addition, it is now recommended that most patients with acute upper GI bleeding should undergo an early endoscopy within 24 hours of presentation. 5 In the current study, only 26.3% of patients underwent an upper endoscopy within 24 hours of presentation. It is clear that clinicians caring for patients with acute upper GI bleeding must focus on risk stratification using validated instruments and provide endoscopy within 24 hours in most patients and selectively earlier in high-risk patients to improve patient outcomes.…”

Predictive Factors for Endoscopic Visibility and Strategies for Pre-endoscopic Prokinetics Use in Patients with Upper Gastrointestinal Bleeding

“…Use of nasogastric lavage (NGL) before endoscopy for emergency management of patients with suspected UGIB remains controversial [17,18,24]. The presence of fresh red blood in NGA is an independent predictor of adverse outcome [25] and is a predictor of high-risk lesions at increased risk for ongoing or recurrent bleeding in patients with UGIB [26,27]. In addition to these prognostic implications, we revealed that the NGA findings were related to endoscopic visibility in patients with UGIB.…”

New insights on an old medical emergency: non-portal hypertension related upper gastrointestinal bleeding

“…A recent study comparing the management of patients taking dabigatran or warfarin in the setting of UGIB concluded that clinical outcomes and length of stay in hospital were comparable between groups (15). The authors also reinforced the need to promptly resume the drug when UGIB is suspected and the inability of fresh frozen plasma in reversing dabigatran's effect (15).…”