CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(06): E774-E781
DOI: 10.1055/a-0880-5312
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

Novel telemetric sensor capsule for EGD urgency triage: a feasibility study

Arthur Schmidt
1   Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
2   Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Germany
,
Melanie Zimmermann
3   Eberhard-Karls-University of Tuebingen, Germany
,
Markus Bauder
2   Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Germany
,
Armin Kuellmer
1   Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
2   Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Germany
,
Karel Caca
2   Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Germany
› Institutsangaben
TRIAL REGISTRATION: Prospective, non-randomized, single center, open-label study NCT03176407 at clinicaltrials.gov
Weitere Informationen

Publikationsverlauf

submitted 24. Oktober 2018

accepted after revision 05. Februar 2019

Publikationsdatum:
17. Mai 2019 (online)

Abstract

Background and study aims Upper gastrointestinal bleeding (UGIB) is a frequent cause of hospitalization. Because of the lack of reliable noninvasive diagnostic tools, the decision to proceed with emergency endoscopy in these cases is made based on clinical parameters. A novel non-imaging telemetric real-time sensor capsule (HemoPill Acute, Ovesco Endoscopy AG) has shown promising results for noninvasive detection of UGIB in preclinical studies.

Patients and methods We conducted a prospective non-randomized, single center, open-label study to investigate feasibility and safety of the novel sensor capsule in patients with symptoms of UGIB. The primary aim of the first clinical study was to investigate feasibility and safety of the device in a clinical setting. All patients underwent endoscopy within 12 hours after capsule ingestion. Sensor data from the capsule within 10 minutes after ingestion were compared with endoscopic findings.

Results From April 2015 to February 2016, 30 consecutive patients with symptoms of acute UGIB were included; 27 were eligible for analysis. Capsule ingestion was well tolerated in all patients and there were no device-related adverse events. Endoscopy showed blood or hematin in the upper gastrointestinal tract of 10 of 27 patients; in 2 of 10 patients it was estimated to be more than 20 mL; in 4 of 8 patients it was between 5 and 20 mL and in 4 of 8 it was estimated to < 5 mL. The sensor capsule was positive in 2 of 2 patients (100 %) with > 20 mL of blood or hematin and in 1 of 8 patients (12.5 %) between 5 and 20 mL. All patients (17/17; 100 %) were correctly identified as non-bleeders.

Conclusion Both device and procedure proved to be safe and feasible. Larger studies will be necessary to evaluate the role of the sensor capsule in risk stratification of patients with acute UGIB.

 
  • References

  • 1 Lau JYW, Barkun A, Fan D. et al. Challenges in the management of acute peptic ulcer bleeding. Lancet 2013; 381: 2033-2043
  • 2 Gralnek IM, Dumonceau J-M, Kuipers EJ. et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2015; 47: a1-46
  • 3 Palamidessi N, Sinert R, Falzon L. et al. Nasogastric aspiration and lavage in emergency department patients with hematochezia or melena without hematemesis. Acad Emerg Med 2010; 17: 126-132
  • 4 Stanley AJ, Laine L, Dalton HR. et al. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study. BMJ 2017; 356: i6432
  • 5 Meltzer AC, Pinchbeck C, Burnett S. et al. Emergency physicians accurately interpret video capsule endoscopy findings in suspected upper gastrointestinal hemorrhage: a video survey. Acad Emerg Med 2013; 20: 711-715
  • 6 Schostek S, Zimmermann M, Keller J. et al. Telemetric real-time sensor for the detection of acute upper gastrointestinal bleeding. Biosens Bioelectron 2016; 78: 524-529
  • 7 Schostek S, Zimmermann M, Keller J. et al. Volunteer Case series of a new telemetric sensor for blood detection in the upper gastrointestinal tract: the HemoPill. Dig Dis Sci 2016; 61: 2956-2962
  • 8 Prosst RL, Schurr MO, Schostek S. et al. Porcine survival model to simulate acute upper gastrointestinal bleedings. Lab Anim 2016; 50: 217-220
  • 9 Hawkey GM, Cole AT, Mcintyre AS. et al. Drug treatments in upper gastrointestinal bleeding : value of endoscopic findings as surrogate end points. Gut 2001; 49: 372-379
  • 10 Schostek S, Zimmermann M, Keller J. et al. Telemetric real-time sensor for the detection of acute upper gastrointestinal bleeding. Biosens Bioelectron 2016; 78: 524-529