[Stress ulceration related bleeding (SURB) in intensive care unit]

Today in critically ill patients the frequency of major stress ulceration related bleeding (SURB) has decreased. However this syndrome has not totally disappeared and its mortality remains very high once it develops. It's high mortality seems to be due to the facts that pathogenesis of SURB is mucosal ischemia resulting from splanchnic hypoperfusion in the setting of various insults in the ICU and that SURB reflects gut failure as a part of multiple organ failure (MOF). Therefore in the prevention of SURB, the optimization of tissue oxygen metabolism in splanchnic area must be considered in addition to the common prophylactic measures such as decreasing or neutralizing gastric acid and protecting gut mucosa.