Evidence map›Paper›PMID 36112271›Full record

SynthesisDigestive diseases and sciences2023

Erythromycin Improves the Quality of Esophagogastroduodenoscopy in Upper Gastrointestinal Bleeding: A Network Meta-Analysis.

Muhammad Aziz, Hossein Haghbin, Manesh Kumar Gangwani, Simcha Weissman, Arti R Patel, Manraj K Randhawa, Luke B Samikanu, Zakaria Abdullah Alyousif, Wade Lee-Smith, Faisal Kamal and 2 more

Abstract readSystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Digestive diseases and sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 3 pooled it
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 3 syntheses or guidelines pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Review
  5. Article
  6. [Non-Variceal Upper Gastrointestinal Bleeding].The Korean journal of helicobacter and upper gastrointestinal research · 2024
    Review
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 1 country.

Muhammad Aziz *Division of Gastroenterology and Hepatology, University of Toledo, Toledo, OH, USA. marajani@hotmail.com.ORCID http://orcid.org/0000-0001-5620-8597
Hossein Haghbin *Division of Gastroenterology, Ascension Providence Southfield, Southfield, MI, USA.
Manesh Kumar GangwaniDepartment of Internal Medicine, University of Toledo, Toledo, OH, USA.
Simcha WeissmanDepartment of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA.
Arti R PatelDepartment of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA.
Manraj K RandhawaDepartment of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA.
Luke B SamikanuDepartment of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA.
Zakaria Abdullah AlyousifRespiratory Care, University of Toledo, Toledo, OH, USA.
Wade Lee-SmithUniversity of Toledo Libraries, University of Toledo, Toledo, OH, USA.
Faisal KamalDivision of Gastroenterology, University of California San Francisco, San Francisco, CA, USA.
Ali NawrasDivision of Gastroenterology and Hepatology, University of Toledo, Toledo, OH, USA.
Colin W HowdenDivision of Gastroenterology, University of Tennessee College of Medicine, Memphis, TN, USA.
University of Toledo · USHackensack Meridian Health · USAscension Providence Hospital · USUniversity of California, San Francisco · USUniversity of Tennessee Health Science Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

aimUpper gastrointestinal bleeding (UGIB) usually requires esophagogastroduodenoscopy (EGD) for diagnostic and-potentially-therapeutic purposes. However, blood within the gastric lumen may hinder the procedure. Administration of prokinetics like erythromycin has shown efficacy. This network meta-analysis investigates the efficacy of this intervention prior to EGD.

methodsWe performed a systematic literature search of Embase, PubMed/Medline, and other databases through March 8, 2022 to include randomized controlled trials (RCTs) comparing prokinetic use in EGD for UGIB. We used the DerSimonian-Laird approach to pool data and compare outcomes including need for repeat endoscopy and blood transfusion. Pooled prevalence of proportional outcomes, 95% confidence interval (CI), and p-values were calculated.

resultsWe included eight RCTs with four distinct intervention groups (erythromycin, placebo to erythromycin, nasogastric (NG) lavage and NG lavage + erythromycin) published between 2002 and 2020 with a total of 721 patients (mean age 60.0 ± 3.1 years; 73.2% male). The need for second look endoscopy was significantly lower with erythromycin than placebo (relative risk: 0.42, CI 0.22-0.83, p = 0.01). Using the frequentist approach, the combination of NG lavage and erythromycin (92.2) was rated highest, followed by erythromycin alone (73.1) for higher rates of empty stomach. Erythromycin was rated highest for lower need for packed red blood cell transfusion (72.8) as well as mean endoscopy duration (66.0).

conclusionErythromycin improved visualization at EGD, reduced requirements for blood transfusion and repeat EGD, and shortened hospital stay. The combination of erythromycin and NG lavage showed reduced mortality.

Indexed as

ErythromycinGastrointestinal AgentsEndoscopy, GastrointestinalFemaleGastrointestinal HemorrhageHumansMaleMiddle AgedRandomized Controlled Trials as TopicErythromycinGastrointestinal AgentsErythromycinEsophagogastroduodenoscopyMortalityNasogastric lavageUpper gastrointestinal bleeding

Identifiers

PMID36112271
OpenAlexW4296027753

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.