Quality standard

Quality statement 8: N‑butyl‑2‑cyanoacrylate for gastric variceal bleeding

Quality statement 8: N‑butyl‑2‑cyanoacrylate for gastric variceal bleeding

Quality statement

People with acute upper gastrointestinal bleeding from gastric varices are given an endoscopic injection of N‑butyl‑2‑cyanoacrylate.

Rationale

Endoscopic injection of N‑butyl‑2‑cyanoacrylate can obliterate gastric varices, whereas attempts at banding are likely to be unsuccessful for these varices.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements to ensure that people with acute upper gastrointestinal bleeding from gastric varices are given an endoscopic injection of N‑butyl‑2‑cyanoacrylate.

Data source: Local data collection.

Process

Proportion of people with acute upper gastrointestinal bleeding from gastric varices who receive endoscopic injection of N‑butyl‑2‑cyanoacrylate.

Numerator – the number of people in the denominator who receive endoscopic injection of N‑butyl‑2‑cyanoacrylate.

Denominator – the number of people with acute upper gastrointestinal bleeding from gastric varices.

Data source: Local data collection.

Outcome

Rates of uncontrolled bleeding in people with acute upper gastrointestinal bleeding from gastric varices.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers ensure that systems are in place for people with acute upper gastrointestinal bleeding from gastric varices to be given an endoscopic injection of N‑butyl‑2‑cyanoacrylate.

Healthcare practitioners give an endoscopic injection of N‑butyl‑2‑cyanoacrylate to people with acute upper gastrointestinal bleeding from gastric varices.

Commissioners ensure that they commission services that give an endoscopic injection of N‑butyl‑2‑cyanoacrylate to people with upper gastrointestinal bleeding from gastric varices.

People with acute upper gastrointestinal bleeding caused by enlarged veins in the stomach are given an injection of N‑butyl‑2‑cyanoacrylate, a substance that helps to stop the bleeding. This injection is given using an endoscope (a narrow, flexible tube with a camera at its tip).

Source guidance

Acute upper gastrointestinal bleeding in over 16s: management. NICE guideline CG141 (2012, updated 2016), recommendation 1.5.5