Gastrointestinal Hemorrhage Clinical Trial
Official title:
Does the BioVac Direct Suction Device Increase Identification of the Bleeding Source in Upper Gastrointestinal Bleeding: a Randomized Clinical Trial
Upper endoscopy is performed for upper gastrointestinal bleeding (bleeding in the esophagus,
stomach, or part of the duodenum) to identify and potentially treat the cause of bleeding.
However, blood clots often make visualization difficult during endoscopy. The current
practice is to try to wash off and suction up these blood clots with the endoscope. However,
this is often not successful due to blood clots blocking the suction channel.
A new device has been approved by Health Canada that attaches to the endoscope and helps
prevent blockage. It is believed that this device will help doctors suck out blood clots and
potentially improve visualization, identification of the cause of bleeding, and possibly
health outcomes, although this has never been proven. The purpose of the this clinical trial
is to test whether the device works and whether it can help patients with this type of
bleeding.
STUDY DESIGN:
This is a randomized double blind clinical trial of the BioVac suction device versus
standard endoscopy suction for UGIB. The study will be performed at London Health Sciences
Center Victoria Campus and University Campus with an anticipated recruitment period of 2.5
years.
STUDY POPULATION:
All patients over the age of 18 admitted to hospital with a diagnosis of UGIB will be
considered for recruitment. Patients already admitted to hospital with another diagnosis who
develop UGIB will also be included.
INTERVENTION:
Patients will undergo EGD for UGIB as per standard clinical practice. If the bleeding source
is not found within the first 5 minutes (timer starts once EGD passes upper esophageal
sphincter) due to blood clots, the patient may benefit from additional suctioning. The
patient will be randomized in blocks of 2-6 stratified by site to either the BioVac device
or endoscopy suction. Those randomized to the BioVac device will use it to irrigate and
suction as much blood as possible until the bleeding source is found or until the
endoscopist feels that additional time would not help. Those randomized to endoscopy suction
will do the same without the BioVac device. Due to the suctioning power of the study device,
a placebo is not possible. Our original intention was to record the endoscopy video to
blindly assess the outcome. Unfortunately, this ended up not being possible for technical
reasons.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Diagnostic
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