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[Stress ulcerations: pathogenesis and prevention].

K H Holtermüller, B Ebener, H J Kühl

    Zeitschrift Fur Gastroenterologie
    |March 1, 1983
    PubMed
    Summary
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    Preventing stress ulcers in critically ill patients involves reducing stomach acid. Maintaining a gastric pH above 3.5 with antacids or cimetidine effectively prevents major gastrointestinal bleeding.

    Area of Science:

    • Gastroenterology
    • Critical Care Medicine

    Background:

    • Clinically inapparent gastric stress ulcerations are common in patients with extensive trauma, intracranial diseases, burns, sepsis, or respiratory insufficiency.
    • While acute erosions often resolve with underlying disease improvement, approximately 20% of patients face major gastrointestinal bleeding.
    • Gastric acid presence is a necessary factor for the development of acute stress lesions.

    Purpose of the Study:

    • To investigate prophylactic strategies against stress ulcerations and their severe complication, exsanguinating hemorrhage.
    • To evaluate the efficacy of decreasing intragastric hydrogen ion concentration for preventing stress erosions.

    Main Methods:

    • Review of clinical trials documenting the effects of gastric content neutralization.
    • Focus on maintaining intragastric pH at 3.5 or higher.

    Related Experiment Videos

    Main Results:

    • Neutralization of gastric content effectively prevents stress ulcers.
    • Elevating intragastric pH to 3.5 or higher prevents life-threatening exsanguinating hemorrhage.

    Conclusions:

    • Critically ill patients require prophylactic measures to prevent acute stress ulcerations.
    • High-dose antacids or cimetidine combined with antacids are recommended for prophylaxis.