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重症监护环境下胃肠道出血的管理:最新文献综述

Management of gastrointestinal bleed in the intensive care setting, an updated literature review.

作者信息

Nagesh Vignesh K, Pulipaka Sai Priyanka, Bhuju Ruchi, Martinez Emelyn, Badam Shruthi, Nageswaran Gomathy Aarthy, Tran Hadrian Hoang-Vu, Elias Daniel, Mansour Charlene, Musalli Jaber, Bhattarai Sanket, Shobana Lokeash Subramani, Sethi Tannishtha, Sethi Ritvik, Nikum Namrata, Trivedi Chinmay, Jarri Amer, Westman Colin, Ahmed Nazir, Philip Shawn, Weissman Simcha, Weinberger Jonathan, Bangolo Ayrton I

机构信息

Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States.

Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States.

出版信息

World J Crit Care Med. 2025 Mar 9;14(1):101639. doi: 10.5492/wjccm.v14.i1.101639.

Abstract

Gastrointestinal (GI) bleeding is a critical and potentially life-threatening condition frequently observed in the intensive care unit (ICU). This literature review consolidates current insights on the epidemiology, etiology, management, and outcomes of GI bleeding in critically ill patients. GI bleeding remains a significant concern, especially among patients with underlying risk factors such as coagulopathy, mechanical ventilation, and renal failure. Managing GI bleeding in the ICU requires a multidisciplinary approach, including resuscitation, endoscopic intervention, pharmacologic therapy, and sometimes surgical procedures. Even with enhanced management strategies, GI bleeding in the ICU is associated with considerable morbidity and mortality, particularly when complicated by multi-organ failure. This review reiterates the need for adequate resuscitation and interventions in managing GI bleeding in critically ill patients, aiming to enhance survival rates and improve the quality of care within the ICU setting.

摘要

胃肠道出血是重症监护病房(ICU)中常见的一种危急且可能危及生命的病症。这篇文献综述整合了目前关于危重症患者胃肠道出血的流行病学、病因、管理及预后的见解。胃肠道出血仍然是一个重大问题,尤其是在有潜在风险因素(如凝血功能障碍、机械通气和肾衰竭)的患者中。在ICU中管理胃肠道出血需要多学科方法,包括复苏、内镜干预、药物治疗,有时还需要手术。即使采用了强化管理策略,ICU中的胃肠道出血仍与相当高的发病率和死亡率相关,特别是在并发多器官功能衰竭时。这篇综述重申了在管理危重症患者胃肠道出血时进行充分复苏和干预的必要性,旨在提高生存率并改善ICU环境中的护理质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d8b/11671843/6e6be203ac8b/101639-g001.jpg

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