Stress ulcer bleeding

Autor: Richard F. Harty, Hari B. Ancha
Rok vydání: 2006
Předmět:
Zdroj: Current Treatment Options in Gastroenterology. 9:157-166
ISSN: 1534-309X
1092-8472
DOI: 10.1007/s11938-006-0034-3
Popis: Although upper gastrointestinal (GI) bleeding from stress-related mucosal disease (SRMD) in critically ill patients is common, significant bleeding with hemodynamic instability is not. Risk factor assessment can assist in identifying patients with a greater likelihood of developing significant SRMD. Prophylaxis against stress ulcer bleeding with luminal agents (eg, antacids and sucralfate) or drugs that inhibit acid secretion (eg, histamine 2-receptor antagonists [H2RAs] and proton-pump inhibitors [PPIs]) can reduce major bleeding but has little or no effect on mortality. Currently, the mainstays of prophylactic therapy for SRMD are intravenously administered H2RAs and PPIs. Wider usage of PPIs reflects their enhanced efficacy in suppressing acid secretion as well as lack of tolerance for H2RAs. Guidelines for the prophylactic use of H2RAs or PPIs in treatment of SRMD will require large, randomized studies that also examine cost effectiveness of individual strategies.
Databáze: OpenAIRE
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