Abstract

PINHO, R.  and  ROMAOZINHO, J. M.. Profilaxia de Úlceras de Stresse numa Unidade de Cuidados Intensivos: Estado da Arte. J Port Gastrenterol. [online]. 2008, vol.15, n.5, pp.202-210. ISSN 0872-8178.

Stress related mucosal lesions of the gastro-duodenal mucosa are common in the intensive care setting. They may result in clinically significant gastrointestinal bleeding with increased mortality. Splanchnic hypoperfusion has a central role in their pathophysiology. Several risk factors were identified, the most important being respiratory failure requiring mechanical ventilation and coagulopathy. Fluid resuscitation and enteral nutrition are important measures to prevent these lesions. Pharmacologic prophylaxis is indicated in patients with known risk factors. Anti-acids, sucralfate and H2-receptor antagonists are the most extensively studied drugs. Recent studies evaluating the role of proton pump inhibitors were published. The choice of the  prophylactic regimen should be based on the route of administration, possible advantages and disadvantages of the drugs, including their comparative cost and available evidence of their efficacy.

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