EBQ:Nasogastric aspiration and lavage in emergency department patients with hematochezia or melena without hematemesis: Difference between revisions
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==Criticisms & Further Discussion== | ==Criticisms & Further Discussion== | ||
# Numbered list item | # Numbered list item All three studies reviewed are retrospective cross-sectional studies, only one of which blinded data abstractors to outcomes. | ||
All three studies reviewed are retrospective cross-sectional studies, only one of which blinded data abstractors to outcomes. | # Numbered list item All studies used a different reference (or 'gold') standard: active bleeding versus stigmata or recent bleeding or | ||
# Numbered list item | |||
All studies used a different reference (or 'gold') standard: active bleeding versus stigmata or recent bleeding or | |||
==Funding== | ==Funding== | ||
Revision as of 23:13, 5 October 2014
incomplete Journal Club Article
Palamidessi N. et al. "Nasogastric aspiration and lavage in emergency department patients with hematochezia or melena without hematemesis". Academic Emergency Medicine. 2010. 17(2):126-32.
PubMed Full text PDF
PubMed Full text PDF
Clinical Question
Is nasogastric lavage and aspiration in the ED an effective test to distinguish between an upper versus lower source of GI bleed in patients who have either melena or hematochezia without hematemesis?
Conclusion
Major Points
Study Design
Systematic literature review.
Population
Patient Demographics
Inclusion Criteria
Cross sectional studies in which all patients presenting with melena or hematochezia underwent nasogastric aspiration (with or without lavage) followed by esophagogastroduodenal endoscopy (EGD).
Exclusion Criteria
Studies that included patients with esophageal varices, hematemesis, or coffee ground emesis.
Interventions
Outcomes
Primary Outcome
Accuracy of nasogastric aspiration in identifying an upper source of gastrointestinal bleed.
Secondary Outcomes
Complications from nasogastric tube insertion.
Subgroup analysis
Criticisms & Further Discussion
- Numbered list item All three studies reviewed are retrospective cross-sectional studies, only one of which blinded data abstractors to outcomes.
- Numbered list item All studies used a different reference (or 'gold') standard: active bleeding versus stigmata or recent bleeding or