IDDF2019-ABS-0083 The use of hemospray endotherapy in patients with acute gastrointestinal bleeding: a philippine experience
Bibliographic record
Abstract
Background Hemospray (TC-325) is a novel hemostatic agent recently licensed for endoscopic hemostasis of non-variceal upper gastrointestinal (GI) bleeding in Europe, Canada and America. It acts by creating a mechanical barrier and effecting hemostasis on actively bleeding lesions via endoscopy. After an extensive search of publications, the group only found one research describing the experience of hemospray use in the local Asian setting done in 2011. This study aims to describe the effectiveness of hemospray therapy on patients treated at the St. Luke’s Medical Center, Global City (SLMC GC), Philippines. Methods A retrospective study was done on consecutive adults with upper and lower active gastrointestinal tract bleeding treated with hemospray at SLMC GC since its introduction in 2017. Data on patient profile, details of the procedure, and indications of hemospray use either as monotherapy or as salvage therapy were collected. Outcomes including primary hemostasis and re-bleeding rates were analyzed. Results From 2017 to 2018, a total of 8 patients with acute GI bleeding were managed with hemospray at SLMC GC. With an age range of 36–83 years old, these patients presented with hematochezia, hematemesis or melena. 3 of the cases had a bleeding gastric mass, 3 had bleeding ulcers, while 2 had portal hypertensive bleeding. Hemospray powder was applied on the identified bleeding sites via endoscopy (figure 1A)(figure 1B.). The rate of successful initial hemostasis after hemospray was 87.5% (7/8). In terms of the endoscopic hemostatic methods used, of the 8 patients, 4 (50%) had hemospray as monotherapy and another 4 (50%) as salvage therapy after argon plasma coagulation, endoclipping or epinephrine sclerotherapy did not achieve hemostasis. All patients (100%) achieved immediate hemostasis. Only 1 (12.5%) patient rebled within the 7 days post-hemospray application for which he underwent surgery 5 days after hemospray due to persistent hematochezia. Conclusions Hemospray is a novel endoscopic technique that has advantages of being non-traumatic, noncontact and can cover large areas of mucosa. This report supports existing studies and demonstrates that hemospray is a safe and effective endoscopic therapy in achieving initial hemostasis, both as primary and salvage therapy in different etiologies of bleeding.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".