Brunk Thomas, Schmidt Arthur, Hochberger Juergen, Wedi Edris, Meier Benjamin, Braun Georg, Neser Frank, Schneider Maximilian, Kandler Jennis, Bauerfeind Peter, Repp Michael, Weingart Vincens, Brand Markus, Caca Karel, Wannhoff Andreas, Messmann Helmut, Karpynec Symon, Kubisch Ilja, Albert Joerg, Neuhaus Horst, Schmitz Lukas, Allescher Hans-Dieter, Meining Alexander, Kuellmer Armin
Department of Gastroenterology, Vivantes Hospital Friedrichshain Berlin, Berlin, Germany.
Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.
Minim Invasive Ther Allied Technol. 2022 Jun;31(5):704-711. doi: 10.1080/13645706.2021.1954534. Epub 2021 Aug 3.
Risk stratification in upper gastrointestinal bleeding (UGIB) currently relies on clinical parameters and risk scores. HemoPill acute (Ovesco Endoscopy, Tuebingen, Germany) is a pill-shaped, orally administered sensor capsule for real-time blood detection. The aim of this study was to evaluate the system in clinical routine.
Sixty-one consecutive patients in whom the HemoPill had been used at 12 international hospitals between July 2019 and March 2020 were retrospectively analysed. Indications for application were the clinical suspicion of UGIB, small bowel bleeding, of rebleeding after hemostasis. Primary endpoints were technical success and bleeding detection/exclusion. Secondary endpoints included adverse events and change of clinical course.
The capsule was used in 45 (73%) patients with UGIB, in 12 (20%) patients with small bowel bleeding and in four (7%) patients for exclusion of rebleeding. Technical success was 98%. 35/60 (58%) cases were capsule-positive and among these, endoscopy showed bleeding in 20/35 (57%) cases. None of the 25 capsule-negative patients rebled. Emergency endoscopy could be avoided in 18/25 (72%) cases. Serious adverse events did not occur.
HemoPill-based blood detection is feasible and safe. Negative capsule results might 'downgrade' the need for urgent endoscopy.
目前，上消化道出血（UGIB）的风险分层依赖于临床参数和风险评分。HemoPill急性版（德国图宾根的Ovesco Endoscopy公司生产）是一种药丸形状的口服传感器胶囊，用于实时血液检测。本研究的目的是在临床常规中评估该系统。
回顾性分析了2019年7月至2020年3月期间在12家国际医院使用HemoPill的61例连续患者。应用指征为临床怀疑UGIB、小肠出血或止血后再出血。主要终点是技术成功和出血检测/排除。次要终点包括不良事件和临床病程变化。
45例（73%）UGIB患者、12例（20%）小肠出血患者和4例（7%）用于排除再出血的患者使用了该胶囊。技术成功率为98%。60例中有35例（58%）胶囊检测呈阳性，其中20/35例（57%）经内镜检查显示有出血。25例胶囊检测呈阴性的患者均未再出血。18/25例（72%）患者可避免急诊内镜检查。未发生严重不良事件。
基于HemoPill的血液检测可行且安全。胶囊检测结果为阴性可能会降低紧急内镜检查的必要性。
