Title of article :
Role of acid suppressants in intensive care medicine
Author/Authors :
Michael Tryba، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 2001
Pages :
15
From page :
447
To page :
461
Abstract :
Bleeding from stress-induced mucosal lesions continues to be a potential problem in critically ill patients, although its incidence has decreased dramatically over the past decade. Patients considered to be at risk are those with respiratory failure, coagulopathy, severe burns or tetraplegia. The most important cause of stress ulcer bleeding is tissue hypoxia. Provided that appropriate dosage regimens are administered, all agents approved for stress ulcer prophylaxis may reduce the incidence of overt as well as clinically important bleeding. However, the efficacy of stress ulcer prophylaxis does not correlate with the efficacy of gastric acid inhibition. Although numerous studies have demonstrated that an alkaline gastric juice is associated with gastric Gram-negative bacterial overgrowth, controversy remains over whether the pharmacological suppression of gastric acid in critically ill patients facilitates nosocomial pneumonia. The reasons for these divergent results are discussed, as is a possible association between gastric acid suppression and other systemic infections. Finally, several cost-effectiveness analyses performed over recent years have demonstrated that, in properly selected critically ill patients, stress ulcer prophylaxis is cost-effective.
Keywords :
risk factors , prevention , pathophysiology , bleeding , economics. , acid suppression , stress ulcer , adverse e?ects
Journal title :
Best Practice and Research Clinical Gastroenterology
Serial Year :
2001
Journal title :
Best Practice and Research Clinical Gastroenterology
Record number :
466231
Link To Document :
بازگشت