Lower Gastrointestinal Bleeding in the Emergency Department: High- Volume vs. Low-Volume Peg Bowel Preparation for Colonoscopy: A Randomized Trial.


Journal

Reviews on recent clinical trials
ISSN: 1876-1038
Titre abrégé: Rev Recent Clin Trials
Pays: United Arab Emirates
ID NLM: 101270873

Informations de publication

Date de publication:
2023
Historique:
received: 23 05 2022
revised: 15 07 2022
accepted: 16 08 2022
pubmed: 13 9 2022
medline: 28 3 2023
entrez: 12 9 2022
Statut: ppublish

Résumé

Lower Gastrointestinal Bleeding (LGIB) is a common cause of admission to the Emergency Department (ED). Early colonoscopy is the exam of choice for evaluating LGIB, and an adequate colon cleansing is essential. High-volume solution 4L-PEG is largely used, but it has some limitations. Low-volume solution 2L-PEG may improve patient's tolerability and compliance, reducing the time of administration and speeding up the exam. We conducted a randomized 1:1, prospective observational monocentric study in 228 patients (144M/84F) with LGIB. 121 (69M/52F) received the High-Volume, while 107 (75M/32F) received Low-Volume. They completed a "satisfaction questionnaire" (taste and smell, mood, time of taking, general experience). We collected the results of the Boston Bowel Preparation Scale (BBPS) and the final diagnosis. The study was retrospectively registered on clinicaltrial.gov with protocol number NCT0536 2227. A mean value of BBPS 6,3 was achieved by both groups (p=0.57). Regarding smell, taste, mood and time of taking (1 to 5), we do not find any statistically differences. The overall satisfaction between the two preparations was 2.90 for low-volume compared to 3.17 for Highvolume (p=0.06). No side effects were reported. The proportion of patients without an evident source of bleeding was higher in High volume preparations compared to Low-volume (39% vs. 30%, respectively). Low volume bowel preparation showed the same efficacy and tolerability with better satisfaction compared with high volume. Low-volume could represent an effective and more desirable preparation for patients in the ED.

Sections du résumé

BACKGROUND
Lower Gastrointestinal Bleeding (LGIB) is a common cause of admission to the Emergency Department (ED). Early colonoscopy is the exam of choice for evaluating LGIB, and an adequate colon cleansing is essential. High-volume solution 4L-PEG is largely used, but it has some limitations. Low-volume solution 2L-PEG may improve patient's tolerability and compliance, reducing the time of administration and speeding up the exam.
PATIENTS AND METHODS
We conducted a randomized 1:1, prospective observational monocentric study in 228 patients (144M/84F) with LGIB. 121 (69M/52F) received the High-Volume, while 107 (75M/32F) received Low-Volume. They completed a "satisfaction questionnaire" (taste and smell, mood, time of taking, general experience). We collected the results of the Boston Bowel Preparation Scale (BBPS) and the final diagnosis. The study was retrospectively registered on clinicaltrial.gov with protocol number NCT0536 2227.
RESULTS
A mean value of BBPS 6,3 was achieved by both groups (p=0.57). Regarding smell, taste, mood and time of taking (1 to 5), we do not find any statistically differences. The overall satisfaction between the two preparations was 2.90 for low-volume compared to 3.17 for Highvolume (p=0.06). No side effects were reported. The proportion of patients without an evident source of bleeding was higher in High volume preparations compared to Low-volume (39% vs. 30%, respectively).
CONCLUSION
Low volume bowel preparation showed the same efficacy and tolerability with better satisfaction compared with high volume. Low-volume could represent an effective and more desirable preparation for patients in the ED.

Identifiants

pubmed: 36089784
pii: RRCT-EPUB-126241
doi: 10.2174/1574887117666220908152754
doi:

Substances chimiques

Cathartics 0
Polyethylene Glycols 3WJQ0SDW1A

Banques de données

ClinicalTrials.gov
['NCT05362227', 'NCT00000536', 'NCT05362227']

Types de publication

Randomized Controlled Trial Observational Study Clinical Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

76-81

Informations de copyright

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.

Auteurs

Angela Saviano (A)

Emergency Department, Fondazione Policlinico A Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Carmine Petruzziello (C)

Emergency Department, Ospedale San Carlo di Nancy GVM Care & Research, Rome, Italy.

Maria Elena Riccioni (ME)

Endoscopy Unit, Fondazione Policlinico A Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Marcello Di Pumpo (M)

Section of Hygiene, University Department of Health Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.

Martina Petrucci (M)

Emergency Department, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.

Mattia Brigida (M)

Emergency Department, Fondazione Policlinico A Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Christian Zanza (C)

Department of Emergency Medicine-Section of Anesthesia and Critical Care-Michele and Pietro Ferrero Hospital, Verduno, Italy.

Marcello Candelli (M)

Emergency Department, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.

Francesco Franceschi (F)

Emergency Department, Fondazione Policlinico A Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Veronica Ojetti (V)

Emergency Department, Fondazione Policlinico A Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

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