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Gastrointestinal Hemorrhage in Neurosurgical Critical Care

  • Corey R. White
  • Kamila Vagnerova
Chapter

Abstract

Upper gastrointestinal bleeding (UGIB) is a common medical condition that results in high morbidity and mortality. Stress-related ulcers are the most common cause of UGIB in critically ill patients. Mechanical ventilation greater than 48 h and coagulopathy are significant risk factors for stress ulceration and overt GI bleeding. Stress ulcer prophylaxis can include the use of proton pump inhibitors (PPI), histamine H2 receptor antagonists (H2RA), sucralfate, antacids, and enteral nutrition. The initial evaluation of an overt UGIB involves an assessment of hemodynamic stability and the necessity for fluid and blood resuscitation. Upon stabilization of the patient, the use IV PPI, continuous or intermittent dosing, is a first-line pharmacologic intervention in overt UGIB. All patients with UGIB require urgent gastroenterology consultation and endoscopy.

Keywords

Gastrointestinal hemorrhage Upper gastrointestinal bleed (UGIB) Peptic ulcer disease (PUD) Stress ulcer prophylaxis (SUP) Stress ulcer risk factors Proton pump inhibitor (PPI) Histamine H2 receptor antagonists (H2RA) 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Corey R. White
    • 1
  • Kamila Vagnerova
    • 2
  1. 1.Department of NeurologyOregon Health & Science UniversityPortlandUSA
  2. 2.Department of Anesthesiology and Perioperative MedicineOregon Health & Science UniversityPortlandUSA

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