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Article: Omeprazole before endoscopy in patients with gastrointestinal bleeding
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TitleOmeprazole before endoscopy in patients with gastrointestinal bleeding
 
AuthorsLau, JY2 1
Leung, WK2
Wu, JCY2
Chan, FKL2
Wong, VWS2
Chiu, PWY2
Lee, VWY2
Lee, KKC2
Cheung, FKY2
Siu, P2
Ng, EKW2
Sung, JJY2
 
Issue Date2007
 
PublisherMassachusetts Medical Society. The Journal's web site is located at http://content.nejm.org/
 
CitationNew England Journal Of Medicine, 2007, v. 356 n. 16, p. 1631-1640 [How to Cite?]
DOI: http://dx.doi.org/10.1056/NEJMoa065703
 
AbstractBackground: A neutral gastric pH is critical for the stability of clots over bleeding arteries. We investigated the effect of preemptive infusion of omeprazole before endoscopy on the need for endoscopic therapy. Methods: Consecutive patients admitted with upper gastrointestinal bleeding underwent stabilization and were then randomly assigned to receive either omeprazole or placebo (each as an 80-mg intravenous bolus followed by an 8-mg infusion per hour) before endoscopy the next morning. Results: Over a 17-month period, 638 patients were enrolled and randomly assigned to omeprazole or placebo (319 in each group). The need for endoscopic treatment was lower in the omeprazole group than in the placebo group (60 of the 314 patients included in the analysis [19.1%] vs. 90 of 317 patients [28.4%], P=0.007). There were no significant differences between the omeprazole group and the placebo group in the mean amount of blood transfused (1.54 and 1.88 units, respectively; P=0.12) or the number of patients who had recurrent bleeding (11 and 8, P=0.49), who underwent emergency surgery (3 and 4, P=1.00), or who died within 30 days (8 and 7, P=0.78). The hospital stay was less than 3 days in 60.5% of patients in the omeprazole group, as compared with 49.2% in the placebo group (P=0.005). On endoscopy, fewer patients in the omeprazole group had actively bleeding ulcers (12 of 187, vs. 28 of 190 in the placebo group; P=0.01) and more omeprazole-treated patients had ulcers with clean bases (120 vs. 90, P=0.001). Conclusions: Infusion of high-dose omeprazole before endoscopy accelerated the resolution of signs of bleeding in ulcers and reduced the need for endoscopic therapy. Copyright © 2007 Massachusetts Medical Society.
 
ISSN0028-4793
2013 Impact Factor: 54.420
 
DOIhttp://dx.doi.org/10.1056/NEJMoa065703
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLau, JY
 
dc.contributor.authorLeung, WK
 
dc.contributor.authorWu, JCY
 
dc.contributor.authorChan, FKL
 
dc.contributor.authorWong, VWS
 
dc.contributor.authorChiu, PWY
 
dc.contributor.authorLee, VWY
 
dc.contributor.authorLee, KKC
 
dc.contributor.authorCheung, FKY
 
dc.contributor.authorSiu, P
 
dc.contributor.authorNg, EKW
 
dc.contributor.authorSung, JJY
 
dc.date.accessioned2012-09-05T05:27:14Z
 
dc.date.available2012-09-05T05:27:14Z
 
dc.date.issued2007
 
dc.description.abstractBackground: A neutral gastric pH is critical for the stability of clots over bleeding arteries. We investigated the effect of preemptive infusion of omeprazole before endoscopy on the need for endoscopic therapy. Methods: Consecutive patients admitted with upper gastrointestinal bleeding underwent stabilization and were then randomly assigned to receive either omeprazole or placebo (each as an 80-mg intravenous bolus followed by an 8-mg infusion per hour) before endoscopy the next morning. Results: Over a 17-month period, 638 patients were enrolled and randomly assigned to omeprazole or placebo (319 in each group). The need for endoscopic treatment was lower in the omeprazole group than in the placebo group (60 of the 314 patients included in the analysis [19.1%] vs. 90 of 317 patients [28.4%], P=0.007). There were no significant differences between the omeprazole group and the placebo group in the mean amount of blood transfused (1.54 and 1.88 units, respectively; P=0.12) or the number of patients who had recurrent bleeding (11 and 8, P=0.49), who underwent emergency surgery (3 and 4, P=1.00), or who died within 30 days (8 and 7, P=0.78). The hospital stay was less than 3 days in 60.5% of patients in the omeprazole group, as compared with 49.2% in the placebo group (P=0.005). On endoscopy, fewer patients in the omeprazole group had actively bleeding ulcers (12 of 187, vs. 28 of 190 in the placebo group; P=0.01) and more omeprazole-treated patients had ulcers with clean bases (120 vs. 90, P=0.001). Conclusions: Infusion of high-dose omeprazole before endoscopy accelerated the resolution of signs of bleeding in ulcers and reduced the need for endoscopic therapy. Copyright © 2007 Massachusetts Medical Society.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationNew England Journal Of Medicine, 2007, v. 356 n. 16, p. 1631-1640 [How to Cite?]
DOI: http://dx.doi.org/10.1056/NEJMoa065703
 
dc.identifier.doihttp://dx.doi.org/10.1056/NEJMoa065703
 
dc.identifier.eissn1533-4406
 
dc.identifier.epage1640
 
dc.identifier.f10001080889
 
dc.identifier.f10001080889
 
dc.identifier.f10001080889
 
dc.identifier.f10001080889
 
dc.identifier.f10001080889
 
dc.identifier.f10001080889
 
dc.identifier.issn0028-4793
2013 Impact Factor: 54.420
 
dc.identifier.issue16
 
dc.identifier.pmid17442905
 
dc.identifier.scopuseid_2-s2.0-34247260475
 
dc.identifier.spage1631
 
dc.identifier.urihttp://hdl.handle.net/10722/163071
 
dc.identifier.volume356
 
dc.languageeng
 
dc.publisherMassachusetts Medical Society. The Journal's web site is located at http://content.nejm.org/
 
dc.publisher.placeUnited States
 
dc.relation.ispartofNew England Journal of Medicine
 
dc.relation.referencesReferences in Scopus
 
dc.titleOmeprazole before endoscopy in patients with gastrointestinal bleeding
 
dc.typeArticle
 
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Author Affiliations
  1. Prince of Wales Hospital Hong Kong
  2. Chinese University of Hong Kong