Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Science review: The use of proton pump inhibitors for gastric acid suppression in critical illness. | Available online http content 9 1 45 Review Science review The use of proton pump inhibitors for gastric acid suppression in critical illness Stephen Brett Consultant in Intensive Care Medicine Department of Anaesthetics and Intensive Care Hammersmith Hospital London UK Corresponding author Stephen Brett Published online 8 October 2004 Critical Care 2005 9 45-50 DOI cc2980 This article is online at http content 9 1 45 2004 BioMed Central Ltd Abstract Prophylaxis is routinely provided for critically ill patients admitted to intensive care units ICUs who are at high risk for stress-related mucosal damage SRMD an erosive process of the gastroduodenum associated with abnormally high physiological demands. Traditionally treatment options have included sucralfate antacids and histamine H2 receptor antagonists H2RAs . The H2RAs are currently the most widely used agents in prophylactic acid suppression however proton pump inhibitors PPIs have recently replaced H2RAs in the treatment of many acid-related conditions. PPIs achieve a more rapid and sustained increase in gastric pH and are not associated with the rapid tachyphylaxis seen with H2RAs. As a result and after the introduction of intravenous formulations PPIs are beginning to be used for the prophylaxis of SRMD in critically ill adults. The high prevalence of renal and hepatic impairment among the ICU population as well as the need for multiple drug therapy in many patients means that pharmacokinetic characteristics and the potential for drug interactions may be important considerations in the choice of prophylactic agent. This review seeks to present the pharmacological evidence that may inform decision-making about the prescription of drugs for prophylaxis of SRMD. Keywords histamine H2 receptor antagonists intensive care units omeprazole pantoprazole proton pump inhibitors Stress ulcer prophylaxis in critically ill patients Stress-related mucosal damage
