Original Article: Clinical EndoscopyProkinetics in acute upper GI bleeding: a meta-analysis
Section snippets
Search strategy
A computerized medical literature search was initiated from January 1990 to January 2010 using OVID MEDLINE (1990 to January 2010), EMBASE (1990 to the first week of 2010), CENTRAL (1st quarter of 2010), and ISI Web of Knowledge 4.0. Abstracts for the past 5 years from Digestive Disease Week and United European Gastroenterology Week (UEGW) were also hand searched as was a clinical trials database (www.clinicaltrials.gov). To select articles, a highly sensitive search strategy was used to
Included studies
From a total of 487 citations identified through the systematic review, 478 articles were excluded because they did not address the topic under study. One article had no randomization performed, 1 had different outcomes assessed, 1 presented insufficient information, and a last was excluded because its results were not available in either English or French. The corresponding Quorum diagram is shown in Figure 1.16 Three fully published articles and 2 clinical studies6, 7, 8 published only in
Discussion
Erythromycin exhibits motilin agonist properties and is used in gastroparesis.21 Its safety profile as an antibiotic is also quite favorable, with caution needed in patients with a prolonged QT interval.22 Its administration and that of metoclopramide before endoscopy have been recently studied in UGIB patients.
The administration of erythromycin or metoclopramide to patients with evidence of ongoing active bleeding and blood in the stomach (hematemesis or coffee ground vomiting and bloody
References (24)
- et al.
Nasogastric aspirate predicts high-risk endoscopic lesions in patients with acute upper-GI bleeding
Gastrointest Endosc
(2004) - et al.
Erythromycin improves the quality of EGD in patients with acute upper GI bleeding: a randomized controlled study
Gastrointest Endosc
(2002) - et al.
Erythromycin intravenous bolus infusion in acute upper gastrointestinal bleeding: a randomized, controlled, double-blind trial
Gastroenterology
(2002) - et al.
Assessing the quality of reports of randomized clinical trials: is blinding necessary?
Control Clin Trials
(1996) - et al.
Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statementQuality of Reporting of Meta-analyses
Lancet
(1999) - et al.
Intravenous metoclopramide to increase mucosal visualization during endoscopy in patients with acute upper gastrointestinal bleeding: a randomized, controlled study [abstract]
Gastrointest Endosc
(2008) - et al.
Erythromycin versus gastric lavage for preendoscopic preparation of patients with upper gastrointestinal bleeding [abstract]
Gastrointest Endosc
(1996) - et al.
Prokinetic agent- metoclopromide increases the yield of upper endoscopy and decreases the need for second look endoscopy in patients with upper gastrointestinal bleed a randomized prospective study [abstract]
Gastrointest Endosc
(2008) - et al.
Overcoming the limitations of current meta-analysis of randomised controlled trials
Lancet
(1998) - et al.
The Canadian Registry on Nonvariceal Upper Gastrointestinal Bleeding and Endoscopy (RUGBE): endoscopic hemostasis and proton pump inhibition are associated with improved outcomes in a real-life setting
Am J Gastroenterol
(2004)
Management of acute bleeding from a peptic ulcer
N Engl J Med
A sampling of Canadian practice in managing nonvariceal upper gastrointestinal bleeding before recent guideline publication: is there room for improvement?
Can J Gastroenterol
Cited by (0)
DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: Dr. Barkun: speaker and consultant for and research support from Olympus; consultant for AstraZeneca. Dr. Bardou: financial support from AstraZeneca to attend DDW; consultant for Sanofi-Aventis and Ethypharm. All other authors disclosed no financial relationships relevant to this publication.
See CME section; p. 1249