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Gastric Feedings Effectively Prophylax Against Upper Gastrointestinal Hemorrhage in Burn Patients.
MedLine Citation:
PMID:  21245765     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The purpose of this study was to examine the effectiveness of gastric feeding in prevention of upper gastrointestinal (GI) hemorrhage. A retrospective chart review of 50 consecutive burn intensive care unit patients with admission dates from January 1, 2005, to December 31, 2007, was conducted. Five of 50 patients (10%) developed GI hemorrhage. Three men of 36 developed a GI hemorrhage (8%) compared with 2 of 14 women (14%). Patients who developed hemorrhage had a higher abbreviated burn severity index score of 11 compared with the control group of 9 and having a higher mortality rate of 80% compared with controls of 27%. Those patients who developed abdominal compartment syndrome were more likely to develop GI hemorrhage (40% rate compared with 4% in patients who did not develop abdominal compartment syndrome). Of 13 patients who were not tolerating their tube feed at some point during treatment, 4 developed hemorrhage (31%), whereas only 1 patient who was tolerating his or her tube feed developed hemorrhage (3%). Three of 19 (16%) patients on proton pump inhibitor prophylaxis developed a GI hemorrhage compared with 2 of 31 (6%) of patients who were not undergoing prophylaxis. Because of the potential side effects of proton pump inhibitor prophylaxis, the authors believe that when tolerated, gastric feedings should be the standard prophylaxis to prevent upper gastrointestinal hemorrhage. Acid suppression therapy may only be necessary for patients who are not tolerating their tube feeds, have other abdominal pathologies, or with a previous history of peptic ulcer disease.
Authors:
Haig Yenikomshian; Matthew Reiss; Reza Nabavian; Warren Louis Garner
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-17
Journal Detail:
Title:  Journal of burn care & research : official publication of the American Burn Association     Volume:  -     ISSN:  1559-0488     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101262774     Medline TA:  J Burn Care Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Division of Plastic and Reconstructive Surgery, Keck School of Medicine University of Southern California, Los Angeles.
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