Zusammenfassung
Stressulzera sind Läsionen der Schleimhaut des oberen Gastrointestinaltraktes, die bei Intensivpatienten, insbesondere bei Polytraumen, Schädel-Hirn-Traumen und schweren Verbrennungen, gehäuft auftreten. Kommt es in diesem Zusammenhang zu klinisch relevanten Blutungen, d. h. zu Hämoglobin- und Blutdruckabfall, ist die Mortalität deutlich erhöht. Die Inzidenz klinisch bedeutsamer Blutungen ist jedoch gering (1,5 %), sodass bei weitem nicht alle Patienten einer Intensivstation eine Stressulkusprophylaxe benötigen. In jüngster Zeit mehren sich die Stimmen, die darauf hinweisen, dass H2-Rezeptorantagonisten und Protonenpumpeninhibitoren durch Anhebung des Magen-pH die Gefahr einer nosokomialen Pneumonie sowie einer Infekion mit Clostridium difficile erhöhen. Zu klären ist nun, welche Intensivpatienten eine medikamentöse Stressulkusprophylaxe erhalten sollten und welche nicht.
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Schneider, J. (2015). Stressulkusprophylaxe und -therapie. In: Schwab, S., Schellinger, P., Werner, C., Unterberg, A., Hacke, W. (eds) NeuroIntensiv. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46500-4_14
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