54. Non-Variceal GI Bleeds

In this episode of Critical Care Time, Dr. Nick Mark and Dr. Cyrus Askin are joined by Dr. David T. Dulaney, a gastroenterologist, to discuss non-variceal GI bleeds. The episode covers the pathophysiology, risk factors, and risk stratification of GI bleeds, distinguishing between upper and lower GI bleeds and arterial versus venous sources. Dr. Dulaney shares insights on diagnosis, lab work, imaging, and the use of clinical decision support tools like the Glasgow Blatchford score. The doctors discuss the importance of communication and teamwork between the ICU team and the endoscopy team, emphasizing the need for individualized patient assessment and timely intervention. They also touch on treatment options such as PPIs, reversal agents, and interventional radiology, as well as the role of TXA and the importance of adequate bowel preparation for colonoscopies. The episode concludes with a discussion on post-procedural care, re-bleeding, and the need for further research on anticoagulation in patients with recurrent diverticular bleeds.