Nasogastric Lavage in GI Bleeding

15 Nov
WHY DOES THIS MATTER?:

–GI Bleeding can be from an upper or lower source
–consultants/admitting physicians may ask you to place an NG tube and lavage the stomach to help differentiate upper vs. lower GI bleed, if unclear from presentation

DOES IT REALLY HELP?
2010 review: analysis of 3 limited studies to eval this question: “does nasogastric aspiration and lavage in patients with melena or hematochezia and no hematemesis differentiate an upper from lower source of gastrointestinal (GI) bleeding?”

–prevalence of an upper GI source was 32% to 74%
–sensitivity 42-68%
–specificity 54-91%
–positive predictive value (PPV) 41-93%
–negative predictive value (NPV) 61-78%
–complication rates of NG tube insertion 1.6%.                            

BOTTOM LINE:
–low sensitivity, poor NPV, variable specificity & PPV
NG lavage has limited diagnostic utility for GI bleed source

Submitted by T. Boyd.

Reference(s): Palamidessi N, et al. Nasogastric Aspiration and Lavage in Emergency Department Patients with Hematochezia or Melena Without Hematemesis.  Acad Emerg Med. 17 (2); Jan 2010, picture

Advertisements

One Response to “Nasogastric Lavage in GI Bleeding”

Trackbacks/Pingbacks

  1. Ischemic colitis in marathon runners | DAILYEM - March 27, 2014

    […] note: I have gone away as much as possible from NG tubes in these patients, given its limited utility and that its one of the more painful procedures) […]

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: