Haemostatic spray in the management of acute nonvariceal upper gastrointestinal bleeding in children: A single‐centre experience in Singapore

• Published in: JPGN reports 2024-08, Vol.5 (3), p.250-255
• Main Authors: Ho, Christopher Wen Wei, Goh, Lynette Suk‐hui, Ng, Lay Queen, Rajan, Charanya, Logarajah, Veena, Chiou, Fang Kuan
• Format: Article
• Language: English
• Subjects: endoscopy; GI bleeding; haemostasis; Original; paediatrics
• ISSN: 2691-171X; 2691-171X
• DOI: 10.1002/jpr3.12105

Introduction/Objectives Haemostatic spray (HS; Hemospray) is a powder agent for endoscopic haemostasis in patients with acute upper gastrointestinal bleeding (UGIB). It has been shown to be effective and easy to administer. However, published data on efficacy and safety in children remain scarce. Our aim was to describe our experience with the use of HS in the management of UGIB. Patients and Methods A retrospective review was conducted of patients aged 0–18 receiving HS for endoscopic haemostasis from January 2017 to December 2021. Information was obtained on demographics, clinical presentation and comorbidities. Outcomes were successful initial haemostasis and rates of re‐bleeding. Results A total of 25 applications of HS occurred in 23 patients. The median patient age was 8 years (range: 4 months to 16 years). HS was used in 17/25 (68%) applications as monotherapy. Other treatments employed were clip application and adrenaline injection. One hundred per cent initial haemostasis was achieved with three (13.0%) patients who experienced re‐bleeding. All patients tolerated HS applications with no adverse events. Conclusions Our finding supports the use of HS in the management of UGIB in children. HS, either as monotherapy or in combination with other conventional therapy, could potentially be the treatment of choice in children with UGIB with its excellent feasibility and good safety profile. What is Known Haemostatic spray (HS) has been shown to be effective and easy to administer for endoscopic haemostasis in patients with acute upper gastrointestinal bleeding (UGIB). It has the potential to improve outcomes of acute UGIB in children. What is New HS was highly efficacious in the treatment of paediatric acute UGIB, either as monotherapy or in combination with other conventional therapies. 100% initial haemostasis was achieved with a 13% re‐bleeding rate. No adverse events were encountered.