Unmasking lower gastrointestinal bleeding under administration of norepinephrine

Table 1 Clinical, endoscopic and angiographic characteristics of patients

	Case 1	Case 2	Case 3	Case 4
Age (yr)	66	79	94	64
Sex	Male	Male	Female	Male
Reasons for admission	GI bleeding	Amputation	GI bleeding	Inflammatory disease
Shock index > 1	Yes	Yes	Yes	Yes
Heart rate (bpm)	112	106	84	120
Blood pressure (mmHg)	75/50	90/50	80/40	90/60
Comorbidities	PE, AA, Hypertension	DM, Hypertension, PAOD IV	CHD, DM, Hypertension	Hypertension
Glasgow-Blatchford score	12	13	10	13
Packed red cells	17	1	0	2
Time to endoscopy (h)	6.5	6	36	8
Source of bleeding	Diverticular	No bleeding	Diverticular	Diverticular
Location	Cecum	Not located	Sigmoid colon	Cecum
Number of endoscopic interventions	2	0	2	1
Types of intervention	1. Clipping2. Injection	None	1. Injection2. Clipping	1. Clipping
Number of endoscopies(Before/After angiography)	7 (6/1)	4 (2/2)	4 (2/2)	3 (3/0)
Time to angiography (d)	6	4	2	2
CTA	Yes	No	No	Yes
Artery with extravasation	A colica dextra	None	AMI	Ileocolic artery
Side of embolization	End arteries	None	Sigmoid artery	Marginal arteries
Material for embolization	Microcoils	-	Microcoils	Microcoils
Type of embolization (mm)	Ø 3/2	-	Ø 10/5	Ø 3/2
Baseline blood pressure (mmHg)	70/40	90/50	80/50	90/60
Dose of norepinephrine	20 µg	20 µg	40 µg	30 µg
Blood pressure (mmHg) at the time the bleeding was identified	155/8	-	170/90	160/90
Bleeding on provocation	Yes	No	Yes	Yes
Early complications	No	No	No	Ischemia
Endoscopy after coiling	Yes	No	No	No
Late complications	No	No	No	No
Duration of hospital stay (d)	18	16	8	30

AA: Aortic aneurysm; AF: Atrial fibrillation; AMI: Inferior mesenteric artery; CHD: Coronary heart disease; CTA: Computed tomography angiography; DM: Diabetes mellitus; Microcoils: Tornado^® Embolization Coil, Cook Medical; MM: Malignant melanoma; PAOD: Peripheral arterial occlusive disease; PE: Pulmonary embolism.