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Titolo:
Review article: acid suppression in non-variceal acute upper gastrointestinal bleeding
Autore:
Barkun, AN; Cockeram, AW; Plourde, V; Fedorak, RN;
Indirizzi:
Univ Alberta, Div Gastroenterol, Edmonton, AB T6G 2C2, Canada Univ Alberta Edmonton AB Canada T6G 2C2 rol, Edmonton, AB T6G 2C2, Canada McGill Univ, Div Gastroenterol, Montreal, PQ, Canada McGill Univ MontrealPQ Canada , Div Gastroenterol, Montreal, PQ, Canada Dalhousie Univ, Halifax, NS, Canada Dalhousie Univ Halifax NS CanadaDalhousie Univ, Halifax, NS, Canada CHU Montreal, Montreal, PQ, Canada CHU Montreal Montreal PQ CanadaCHU Montreal, Montreal, PQ, Canada
Titolo Testata:
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
fascicolo: 12, volume: 13, anno: 1999,
pagine: 1565 - 1584
SICI:
0269-2813(1999)13:12<1565:RAASIN>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
NONSTEROIDAL ANTIINFLAMMATORY DRUGS; 24-HOUR INTRAGASTRIC-PH; PROSPECTIVE RANDOMIZED TRIAL; PEPTIC-ULCER DISEASE; PLACEBO-CONTROLLED MULTICENTER; ENDOSCOPIC INJECTION THERAPY; PROTON-PUMP INHIBITORS; PHASE-III ACTIVITY; DUODENAL-ULCER; HELICOBACTER-PYLORI;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
129
Recensione:
Indirizzi per estratti:
Indirizzo: Fedorak, RN Univ Alberta, Div Gastroenterol, 519 Robert Newton Res Bldg, Edmonton, AB T6G 2C2, Canada Univ Alberta 519 Robert Newton Res Bldg Edmonton AB Canada T6G 2C2
Citazione:
A.N. Barkun et al., "Review article: acid suppression in non-variceal acute upper gastrointestinal bleeding", ALIM PHARM, 13(12), 1999, pp. 1565-1584

Abstract

Despite a decreased incidence of ulcer disease and improvements in the management of acute upper gastrointestinal (GI) bleeding, mortality remains atabout 6-7%. Although endoscopic haemostatic therapy has been demonstrated to be the mainstay of management, the search continues for less invasive medical modalities that might also improve patient outcome. In vitro data have indicated the important role of acid in impairing haemostasis and causing clot digestion. Therefore, theoretically, maintenance ofa high intragastric pH (above 6.0) during management of upper GI bleeding is warranted. Until recently, available agents did not permit such a sustained elevation in gastric pH. Early studies with H-2-receptor antagonists have not demonstrated significant improvements in important patient outcomes,such as rebleeding, surgery or mortality. With the availability of intravenous formulations of proton pump inhibitors, it is now possible to aim at maintaining gastric pH above 6.0 for 24 h per day. Recent clinical trial data would appear to support the use of proton pump inhibitors to decrease the rate of rebleeding and the need for surgery. This paper provides a review of non-variceal acute GI bleeding, with special reference to the role of proton pump inhibitors in this clinical setting.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 07:15:45