Trial reportGut2019
Early application of haemostatic powder added to standard management for oesophagogastric variceal bleeding: a randomised trial.
Trial report in Gut, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 36 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Control Study to Determine the Efficacy and Safety of Combining Hemospray With Medical Standard of Care Treatment in the Management of Acute Variceal Bleeding in Cirrhotic Patients.
Timing of Endoscopic Intervention in Patients With Cirrhosis With Acute Variceal Upper Gastrointestinal Hemorrhage (TEACH Trial): a Randomized Clinical Trial
Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 102 citations in OpenAlex.
- Treatment for bleeding oesophageal varices in people with decompensated liver cirrhosis: a network meta-analysis.The Cochrane database of systematic reviews · 2021Pooled it
- KASL clinical practice guidelines for liver cirrhosis: Varices, hepatic encephalopathy, and related complications.Clinical and molecular hepatology · 2020Guideline
- Effects of Preoperative Oral Carbohydrate on Cirrhotic Patients under Endoscopic Therapy with Anesthesia: A Randomized Controlled Trial.BioMed research international · 2021Trial
- [Emphasizing the precise application of emergency endoscopy in the treatment of portal hypertensive bleeding in cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Review
- Comprehensive review on the current management of upper-GI bleed.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Review
- The Bleeding Duodenal Varix Dilemma: An Atypical Endoscopic Presentation of Duodenal Variceal Bleed.ACG case reports journal · 2026Article
- Efficacy of hemostatic powder for non-variceal gastrointestinal bleeding: a systematic review and meta-analysis of randomized trials.Therapeutic advances in gastroenterology · 2026Article
- Endoscopic management of acute esophagogastric variceal bleeding: recent advances.Therapeutic advances in gastroenterology · 2026Review
- Endo-hepatology: Bridging the gap between lumen and liver.World journal of gastroenterology · 2025Review
- [Current status of treatment for acute variceal bleeding in liver cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2024Review
- Haemostatic spray in the management of acute nonvariceal upper gastrointestinal bleeding in children: A single-centre experience in Singapore.JPGN reports · 2024Article
- [Endoscopic Treatment and Prevention of Acute Variceal Hemorrhage].The Korean journal of helicobacter and upper gastrointestinal research · 2024Review
- Topical hemostatic agents in the management of upper gastrointestinal bleeding: a meta-analysis.Endoscopy international open · 2023Article
- Article
- Hemostatic powders for gastrointestinal bleeding: a review of old, new, and emerging agents in a rapidly advancing field.Endoscopy international open · 2022Review
- Variceal Bleeding: Beyond Banding.Digestive diseases and sciences · 2022Review
- Minimal and Maximal Extent of Band Ligation for Acute Variceal Bleeding during the First Endoscopic Session.Gut and liver · 2022Article
- Postoperative Complications Associated with Moderate Sedation in Endoscopic Procedures Among Patients with Cirrhosis.Medical science monitor : international medical journal of experimental and clinical research · 2021Article
- Recent Advances in the Management of Acute Variceal Hemorrhage.Journal of clinical medicine · 2021Review
- Managing liver cirrhotic complications: Overview of esophageal and gastric varices.Clinical and molecular hepatology · 2020Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute variceal bleeding (AVB) requires early therapeutic management by experienced endoscopists that often poses logistical challenges for hospitals. We assessed a different management concept with early application of haemostatic powder-which does not require high endoscopic expertise-added to conventional management in a randomised trial.
methodsCirrhotic patients with AVB received standard medical therapy and were randomised to either immediate endoscopy with haemostatic powder application within 2 hours of admission, followed by early elective endoscopy on the next day, that is, within 12-24 hours of admission for definitive treatment (study group) or to early elective endoscopy only (control group). In both groups, failures to achieve clinical haemostasis until the time of early elective endoscopy underwent rescue endoscopy with attempted conventional haemostasis. Primary outcome was endoscopic haemostasis at the elective endoscopy.
resultsOf 86 randomised patients with AVB, 5/43 in the study group required rescue endoscopy for failure of controlling spurting bleeding (n=4) after powder application or for early bleeding recurrence in one patient who died before repeating rescue endoscopy. In the control group, 13/43 patients required rescue endoscopic haemostasis for failure of clinical haemostasis (12%vs30%, p=0.034). In the remaining patients, early elective endoscopic haemostasis was achieved in all 38 patients in the study group, while all remaining 30 patients in the control group had fresh gastric blood or (10%) spurting bleeding at early elective endoscopy with successful haemostasis in all of them. Six-week survival was significantly improved in the study group (7%vs30%, p=0.006).
conclusionThe new concept of immediate powder application improves early clinical and endoscopic haemostasis. This simplified endoscopic approach may have an impact on early and 6-week survival. TRIAL REGISTRATION NUMBER: NCT03061604.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.