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Titolo:
Role of acid suppressants in intensive care medicine
Autore:
Tryba, M;
Indirizzi:
Univ Teaching Hosp, Klinikum Kassel, Dept Anesthesia Intens Care Med & Pain Therapy, D-34125 Kassel, Germany Univ Teaching Hosp Kassel Germany D-34125 erapy, D-34125 Kassel, Germany
Titolo Testata:
BEST PRACTICE & RESEARCH IN CLINICAL GASTROENTEROLOGY
fascicolo: 3, volume: 15, anno: 2001,
pagine: 447 - 461
SICI:
1521-6918(200106)15:3<447:ROASII>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
STRESS-ULCER PROPHYLAXIS; CRITICALLY ILL PATIENTS; VENTILATOR-ASSOCIATED PNEUMONIA; NOSOCOMIAL PNEUMONIA; GASTRIC COLONIZATION; RISK-FACTORS; MECHANICAL VENTILATION; UNIT PATIENTS; TRAUMA PATIENTS; INTUBATED PATIENTS;
Keywords:
stress ulcer; bleeding; pathophysiology; risk factors; prevention; acid suppression; adverse effects; economics;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
75
Recensione:
Indirizzi per estratti:
Indirizzo: Tryba, M Univ Teaching Hosp, Klinikum Kassel, Dept Anesthesia Intens Care Med & Pain Therapy, Moenchebergstr 41-43, D-34125 Kassel, Germany Univ Teaching Hosp Moenchebergstr 41-43 Kassel Germany D-34125 y
Citazione:
M. Tryba, "Role of acid suppressants in intensive care medicine", BEST PR RES, 15(3), 2001, pp. 447-461

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 thosewith 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 illpatients facilitates nosocomial pneumonia. The reasons for these divergentresults 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 properlyselected critically ill patients, stress ulcer prophylaxis is cost-effective.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/01/20 alle ore 01:16:31