Upper Gastrointestinal Bleeding Clinical Trial
Official title:
Impact of Blood Detection Capsule "HemoPill Acute ®" on the Time to Emergency Endoscopy in Case of Suspected Nonvariceal Upper Gastrointestinal Bleeding
Verified date | April 2024 |
Source | Wuerzburg University Hospital |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The study examines, whether the use of the HemoPill Acute ® capsule in case of suspected nonvariceal upper gastrointestinal bleeding can identify cases in which endoscopy can be delayed to 48-96 hours without risk to the patient.
Status | Completed |
Enrollment | 73 |
Est. completion date | April 8, 2024 |
Est. primary completion date | April 8, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Emergency presentation with clinical suspicion of non-variceal upper GI bleeding (e.g. haematin vomiting, melena, etc.) - hemodynamic stable patient (heart rate <100 / min, Blood pressure sys = 100mmHg) - Emergency endoscopy indicated (modified Glasgow-Blatchford-Score = 2 points) - Administration of proton pump inhibitors possible (no allergy known) - Good communication (without translator) with the study doctor and fulfill all requirements of the study - Written consent after detailed information about the study Exclusion Criteria: - Hemodynamically unstable patients (HF> 100 / min, RR <100mmHg despite fluid administration) with indication for endoscopy within 12 hours - Indication for endoscopy within 12 hours recommended by endoscopy call service - Clinical suspicion of variceal bleeding of the upper GI tract (risk factors according to german guidelines: cirrhosis of the liver, splanchnic thrombosis, thrombocytopenia, known increased liver / spleen stiffness, known esophageal varices) - Clinical suspicion of lower GI bleeding (e.g. hematochezia) - Vomiting blood (hematemesis observed by the emergency doctor or in the clinic) - Patients with inflammatory bowel disease (Crohn's disease or ulcerative colitis) - Severe acute and chronic organ diseases that need treatment (e.g. kidney replacement treatment) (ASA =4) - Changed anatomy of the upper GI tract (e.g. gastric resection) - Known or suspected gastrointestinal obstructions, strictures, fistulas or known diverticula - Dysphagia or other swallowing disorders - Awareness restrictions that make it impossible to swallow the HemoPill Acute ® capsule on your own - Patients with pacemakers, defibrillators, or other implantable electromedical devices - Known allergy to parylene (capsule surface) - Soon MRI scan planned - Pregnancy or breastfeeding - Mental impairment that limits the ability to meet all study requirements. |
Country | Name | City | State |
---|---|---|---|
Germany | Klinikum Friedrichshain | Berlin | |
Germany | Universitästklinik Freiburg | Freiburg | |
Germany | Sana Klinikum Offenbach GmbH | Offenbach am Main | |
Germany | Universitätsklinik Würzburg | Würzburg |
Lead Sponsor | Collaborator |
---|---|
Wuerzburg University Hospital | Sana Klinikum Offenbach, University Hospital Freiburg, Vivantes Netzwerk für Gesundheit GmbH |
Germany,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Rate of avoided emergency endoscopies (usually done within 24 hours) in case of negative HemoPill. | In how many cases with a negative HaemoPill, the endoscopy interval can be extended to at least 48 hours without acute re-bleeding (confirmed in unscheduled emergency endoscopy) occurring in the meantime.
The criteria for suspected re-bleeding (leading to an unscheduled emergency endoscopy) are: Hematemesis, again melena or hematochezia after normalized stool, tachycardia (=110 / min) or hypotension (RRsys =90 mm Hg) without other explanation, decrease in the Hb value =2 g/dl in the course without other explanation (e.g. dilution, nosebleeds ), no increase in Hb after transfusion of erythrocyte concentrate (s) (measured after 24 hours). |
48 to 96 hours after swallow the capsule | |
Secondary | Rate of true positive HemoPill results leading to an emergency endoscopic intervention | HemoPill positive and emergency endoscopy with active bleeding / bleeding source | 12 hours after swallow the capsule | |
Secondary | Rate of false positive HemoPill results | HemoPill positive and emergency endoscopy without active bleeding / bleeding source | 12 hours after swallow the capsule | |
Secondary | Rate of false negative HemoPill results | HemoPill negative and clinical signs of bleeding and confirmation in unscheduled emergency endoscopy | 48 to 96 hours after swallow the capsule | |
Secondary | The use of the HemoPill Acute ® capsule as part of emergency care is safe and technically easy. | Measurement of procedural complications | 30 Days after discharge |
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