Open Access Review

Management by the intensivist of gastrointestinal bleeding in adults and children

David Osman1*, Michel Djibré2, Daniel Da Silva3, Cyril Goulenok4 and group of experts

Author Affiliations

1 AP-HP, Hôpitaux universitaires Paris-Sud, Hôpital de Bicêtre, Service de réanimation médicale, Le Kremlin-Bicêtre, F-94270, France

2 AP-HP, Hôpitaux universitaires Est Parisien, Hôpital Tenon, Service de pneumologie et réanimation, Paris, F-75020, France

3 Hôpital Delafontaine, Service de réanimation polyvalente, Saint-Denis, F-93200, France

4 Hôpital Privé Jacques Cartier, Service de réanimation polyvalente, Massy, F-91300, France

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Annals of Intensive Care 2012, 2:46  doi:10.1186/2110-5820-2-46

Published: 9 November 2012

Abstract

Intensivists are regularly confronted with the question of gastrointestinal bleeding. To date, the latest international recommendations regarding prevention and treatment for gastrointestinal bleeding lack a specific approach to the critically ill patients. We present recommendations for management by the intensivist of gastrointestinal bleeding in adults and children, developed with the GRADE system by an experts group of the French-Language Society of Intensive Care (Société de Réanimation de Langue Française (SRLF), with the participation of the French Language Group of Paediatric Intensive Care and Emergencies (GFRUP), the French Society of Emergency Medicine (SFMU), the French Society of Gastroenterology (SNFGE), and the French Society of Digestive Endoscopy (SFED). The recommendations cover five fields of application: management of gastrointestinal bleeding before endoscopic diagnosis, treatment of upper gastrointestinal bleeding unrelated to portal hypertension, treatment of upper gastrointestinal bleeding related to portal hypertension, management of presumed lower gastrointestinal bleeding, and prevention of upper gastrointestinal bleeding in intensive care.

Keywords:
Gastrointestinal bleeding; Intensive care; Ulcer; Gastric/esophageal varices; Recommendations