PMID- 19260486
OWN - NLM
STAT- MEDLINE
DCOM- 20090423
LR  - 20220310
IS  - 0172-6390 (Print)
IS  - 0172-6390 (Linking)
VI  - 55
IP  - 88
DP  - 2008 Nov-Dec
TI  - Risk factors and the role of bedside colonoscopy for lower gastrointestinal 
      hemorrhage in critically ill patients.
PG  - 2108-11
AB  - BACKGROUND/AIMS: We designed this study to determine the clinical characteristics 
      of critically ill patients with lower gastrointestinal hemorrhage (LGIH) and to 
      evaluate the effectiveness of bedside colonoscopy in diagnosing and managing LGIH 
      in the intensive care unit (ICU) setting. METHODOLOGY: We retrospectively 
      reviewed the medical records of patients who underwent bedside colonoscopy for 
      LGIH that developed while in the ICU at Severance Hospital from January 1999 to 
      June 2006. The control group was a random sampling of patients hospitalized in 
      the ICU without GIH. RESULTS: A total of 28,101 patients were hospitalized in ICU 
      during the study period. Of these, 43 patients were included in each group. There 
      were no significant differences in age, sex, and primary and underlying diseases 
      between the two groups. Hypoalbuminemia and high BUN levels were found to be risk 
      factors for LGIH in ICU patients. Bleeding focus was recognized in 28 patients 
      (65.1%) through bedside colonoscopy. Major endoscopic diagnoses were ischemic 
      colitis (13, 30.2%), rectal ulcer (7, 20.9%), and hemorrhoids (6, 13.9%). Primary 
      endoscopic hemostasis was achieved in 11 of 28 diagnosed patients (39.3%). 
      CONCLUSIONS: Our data suggest that patients' underlying conditions may affect 
      LGIH in the ICU setting. Moreover, urgent bedside colonoscopy may be effective in 
      diagnosing and guiding appropriate treatments for LGIH in critically ill 
      patients.
FAU - Kim, Byung Chang
AU  - Kim BC
AD  - Department of Internal Medicine, Institute of Gastroenterology, Yonsei University 
      College of Medicine, Seoul, Korea.
FAU - Cheon, Jae Hee
AU  - Cheon JH
FAU - Kim, Tao Il
AU  - Kim TI
FAU - Kim, Won Ho
AU  - Kim WH
LA  - eng
PT  - Journal Article
PL  - Greece
TA  - Hepatogastroenterology
JT  - Hepato-gastroenterology
JID - 8007849
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Colonoscopy/methods
MH  - Critical Illness
MH  - Female
MH  - Gastrointestinal Hemorrhage/*diagnosis
MH  - Humans
MH  - Intensive Care Units
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Risk Factors
EDAT- 2009/03/06 09:00
MHDA- 2009/04/25 09:00
CRDT- 2009/03/06 09:00
PHST- 2009/03/06 09:00 [entrez]
PHST- 2009/03/06 09:00 [pubmed]
PHST- 2009/04/25 09:00 [medline]
PST - ppublish
SO  - Hepatogastroenterology. 2008 Nov-Dec;55(88):2108-11.