Clinical effect of continuous gastric cooling for massive GI bleeding in uremia.
Continuous gastric cooling (CGC) with dialysate was done in nine hemodiaysis patients with massive gastro-intestinal (GI) bleeding. Eight patients were treated by direct irrigation using a double-lumen naso-gastric (NG) tube without balloon. Four patients with bleeding from the duodenum (B-f-D) had complete hemostasis, and there was only one recurrence. However, two out of four patients with bleeding from the stomach (B-f-S) had complete hemostasis, but all four suffered recurrence. The NG tube had to be reinserted in three patients with B-f-S because of obstruction by clots. The direct irrigation method of CGC thus appears to be more effective for the treatment of B-f-D than B-f-S, so we investigated a three lumen, single-balloon catheter (3L-SBC) with which the bleeding site in the stomach can be cooled and pressed without removing coagula. CGC using the 3L-SBC was done in one patient with B-f-S, and complete hemostasis was obtained without recurrence.
Inagaki
Y
Y
Department of Artificial Organs, Chukyo Hospital, Nagoya-City-Japan.
Amano
I
I
D000328:Adult; D002404:Catheterization / Q000295:instrumentation; D017679:Cryotherapy; D015314:Dialysis Solutions; D005260:Female; D005751:Gastric Lavage; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000517:prevention & control*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D014511:Uremia / Q000150:complications* / Q000628:therapy
D015314:Dialysis Solutions