Vitamin K for upper gastrointestinal bleeding in patients with liver diseases.
BACKGROUND
Upper gastrointestinal bleeding is one of the most frequent causes of morbidity and mortality in the course of liver cirrhosis. Several treatments are used for upper gastrointestinal bleeding in patients with liver diseases. One of them is vitamin K administration, but it is unknown whether it benefits or harms patients with liver disease and upper gastrointestinal bleeding.


OBJECTIVE
To assess the beneficial and harmful effects of vitamin K for patients with liver disease and upper gastrointestinal bleeding.


METHODS
We searched The Cochrane Hepato-Biliary Group Controlled Trials Register (September 2007), which comprises references identified from comprehensive electronic database searches and handsearching of relevant journals and abstract books of conference proceedings, The Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 3, 2007), MEDLINE (1950 to September 2007), EMBASE (1980 to September 2007), Science Citation Index Expanded (1945 to September 2007), and LILACS (1982 to November 2007). Additional randomised trials were sought from two registries of clinical trials, ClinicalTrials.gov and Sistema de Información Esencial en Terapéutica y Salud, the reference lists of the trials found, and reviews identified by the electronic searches.


METHODS
Randomised clinical trials.


METHODS
Data from randomised clinical trials were to be summarised by standard Cochrane Collaboration methodologies.


RESULTS
We could not find any randomised trials on vitamin K for upper gastrointestinal bleeding in patients with liver diseases.


CONCLUSIONS
This updated review found no randomised clinical trials on the safety and efficacy of vitamin K for upper gastrointestinal bleeding in patients with liver diseases. The effects of vitamin K need to be tested in randomised clinical trials. Unless randomised clinical trials provide evidence of a treatment effect and the trade off between potential benefits and harms are established, policy-makers, clinicians, and academics should not use vitamin K for upper gastrointestinal bleeding in patients with liver diseases.
Martí-Carvajal
Arturo J
AJ
Departamento de Salud Pública, Universidad de Carabobo, Centro Colaborador Venezolano de la Red Cochrane Iberoamericana, Valencia, Edo. Carabobo, Venezuela, 2001. amarti@uc.edu.ve
Cortés-Jofré
Marcela
M
Martí-Peña
Arturo J
AJ
D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008107:Liver Diseases / Q000150:complications*; D014812:Vitamin K / Q000627:therapeutic use*
D000933:Antifibrinolytic Agents; D014812:Vitamin K