Hydrogen peroxide improves the visibility of ulcer bases in acute non-variceal upper gastrointestinal bleeding: a single-center prospective study.

Hdl Handle:
http://hdl.handle.net/10675.2/100
Title:
Hydrogen peroxide improves the visibility of ulcer bases in acute non-variceal upper gastrointestinal bleeding: a single-center prospective study.
Authors:
Sridhar, Subbaramiah; Chamberlain, Sherman; Thiruvaiyaru, Dharma; Sethuraman, Sankara; Patel, Jigneshkumar; Schubert, Moonkyung; Cuartas-Hoyos, Francisco; Schade, Robert R.
Abstract:
BACKGROUND: Acute non-variceal upper gastrointestinal bleeding (ANVB) or hemorrhage (used interchangeably) is an emergency. Endoscopically applied hydrogen peroxide (H2O2) has been shown to improve visualization of the ulcer base. AIMS: To test the hypothesis that ulcer base clot clearance with 3% H2O2 improves the visualization of ANVB lesions compared to water alone. METHODS: In this single-center prospective study, 320 patients with ANVB were examined, of which 81 met the entry criteria for evaluation. All patients with ANVB underwent urgent endoscopy. Those with adherent clots on the ulcer base were sprayed with 250 ml of water, followed by up to 100 ml of 3% H2O2. The main outcome measurement was Kalloo"s Visual Scores of the ulcer base before and after water and H2O2. RESULTS: Eighty-one patients with gastric ulcers (GU; 34) and duodenal ulcers (DU; 47) met the entry criteria. The mean improvement in grade from water to H2O2 was 2.04 (95% confidence interval [CI] (1.86, 2.23)). The mean volume of H2O2 used to clear clots was higher (70 ml) in patients who were negative for both Helicobacter pylori and non-steroidal anti-inflammatory drug (NSAID) use than in those who were positive for both (31 ml) (P = 0.00). More DU patients (72%) had visible vessels than GU patients (44%) (P = 0.01). CONCLUSIONS: H2O2 improved the visualization of ulcer bases in ANVB. A smaller volume of H2O2 was required to clear clots in patients who used NSAIDs and had H. pylori infection. H2O2 identified more DU vessels. The use of H2O2 should be considered as a standard therapy in the management of clots in ANVB.
Citation:
Dig Dis Sci. 2009 Nov 10; 54(11):2427-2433
Issue Date:
19-Oct-2009
URI:
http://hdl.handle.net/10675.2/100
DOI:
10.1007/s10620-009-0948-4
PubMed ID:
19757051
PubMed Central ID:
PMC2762049
Type:
Clinical Trial; Journal Article
ISSN:
1573-2568
Appears in Collections:
Department of Medicine Faculty: Research and Presentations

Full metadata record

DC FieldValue Language
dc.contributor.authorSridhar, Subbaramiahen_US
dc.contributor.authorChamberlain, Shermanen_US
dc.contributor.authorThiruvaiyaru, Dharmaen_US
dc.contributor.authorSethuraman, Sankaraen_US
dc.contributor.authorPatel, Jigneshkumaren_US
dc.contributor.authorSchubert, Moonkyungen_US
dc.contributor.authorCuartas-Hoyos, Franciscoen_US
dc.contributor.authorSchade, Robert R.en_US
dc.date.accessioned2010-09-24T22:03:19Z-
dc.date.available2010-09-24T22:03:19Z-
dc.date.issued2009-10-19en_US
dc.identifier.citationDig Dis Sci. 2009 Nov 10; 54(11):2427-2433en_US
dc.identifier.issn1573-2568en_US
dc.identifier.pmid19757051en_US
dc.identifier.doi10.1007/s10620-009-0948-4en_US
dc.identifier.urihttp://hdl.handle.net/10675.2/100-
dc.description.abstractBACKGROUND: Acute non-variceal upper gastrointestinal bleeding (ANVB) or hemorrhage (used interchangeably) is an emergency. Endoscopically applied hydrogen peroxide (H2O2) has been shown to improve visualization of the ulcer base. AIMS: To test the hypothesis that ulcer base clot clearance with 3% H2O2 improves the visualization of ANVB lesions compared to water alone. METHODS: In this single-center prospective study, 320 patients with ANVB were examined, of which 81 met the entry criteria for evaluation. All patients with ANVB underwent urgent endoscopy. Those with adherent clots on the ulcer base were sprayed with 250 ml of water, followed by up to 100 ml of 3% H2O2. The main outcome measurement was Kalloo"s Visual Scores of the ulcer base before and after water and H2O2. RESULTS: Eighty-one patients with gastric ulcers (GU; 34) and duodenal ulcers (DU; 47) met the entry criteria. The mean improvement in grade from water to H2O2 was 2.04 (95% confidence interval [CI] (1.86, 2.23)). The mean volume of H2O2 used to clear clots was higher (70 ml) in patients who were negative for both Helicobacter pylori and non-steroidal anti-inflammatory drug (NSAID) use than in those who were positive for both (31 ml) (P = 0.00). More DU patients (72%) had visible vessels than GU patients (44%) (P = 0.01). CONCLUSIONS: H2O2 improved the visualization of ulcer bases in ANVB. A smaller volume of H2O2 was required to clear clots in patients who used NSAIDs and had H. pylori infection. H2O2 identified more DU vessels. The use of H2O2 should be considered as a standard therapy in the management of clots in ANVB.en_US
dc.rightsThe PMC Open Access Subset is a relatively small part of the total collection of articles in PMC. Articles in the PMC Open Access Subset are still protected by copyright, but are made available under a Creative Commons or similar license that generally allows more liberal redistribution and reuse than a traditional copyrighted work. Please refer to the license statement in each article for specific terms of use. The license terms are not identical for all articles in this subset.en_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 and overen_US
dc.subject.meshEndoscopy, Gastrointestinalen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshHydrogen Peroxide / diagnostic useen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOxidants / diagnostic useen_US
dc.subject.meshPeptic Ulcer Hemorrhage / diagnosisen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshYoung Adulten_US
dc.titleHydrogen peroxide improves the visibility of ulcer bases in acute non-variceal upper gastrointestinal bleeding: a single-center prospective study.en_US
dc.typeClinical Trialen_US
dc.typeJournal Articleen_US
dc.identifier.pmcidPMC2762049en_US
dc.contributor.corporatenameDepartment of Medicineen_US

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