How is upper gastrointestinal (GI) bleeding in neonates treated?

Updated: Dec 19, 2018
  • Author: Wayne Wolfram, MD, MPH; Chief Editor: Robert K Minkes, MD, PhD  more...
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Answer

Treatment for stress gastritis in neonates is supportive and includes adequate resuscitation to reduce the underlying hypoxemia, nasogastric suction, and IV H2 blockers or PPIs. Studies have advocated identifying high-risk neonates and treating them prophylactically with acid-reducing agents. Extremely rarely, continued or massive hematemesis despite medical therapy leads to operative interventions, such as gastric resection, vagotomy and pyloroplasty, or antrectomy and vagotomy.

Hemorrhagic disease of the newborn is a bleeding disorder resulting from a deficiency in vitamin K–dependent coagulation factors. Although it is normally self-limited, in 0.25%-0.5% of neonates, severe hemorrhage may result.

Prophylactic vitamin K administration in the newborn period virtually eliminates hemorrhagic disease. If the disorder occurs, IV administration of 1 mg of vitamin K generally stops the hemorrhage within 2 hours. If the clinical condition warrants, fresh frozen plasma and packed red blood cells are administered in addition to the vitamin K.


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