Zusammenfassung
Eine generelle Prophylaxe von Stressulzera kann bei Patienten einer chirurgischen Intensivstation nicht empfohlen werden. Von einer Säuresekretionshemmung profitieren jedoch Patienten mit Risikofaktoren. Zu den Risikofaktoren zählen insbesondere Polytraumata, Verbrennungen und neurochirurgische Eingriffe. Stressulzera werden wie unkomplizierte Ulzera des oberen Gastrointestinaltraktes therapiert; Blutungen können endoskopisch gestillt werden. Bei der Primärprophylaxe sind H2-RA der Behandlung mit Sucralfat oder Antazida überlegen und werden in der Regel bei leichteren Fällen eingesetzt. Patienten mit hohem Risiko profitieren von der Behandlung mit PPI.
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