Bezarro E R
Crit Care Nurs Clin North Am. 1993 Jun;5(2):325-31.
Bleeding from stress-related mucosal damage is a feared complication in critically ill patients. For the past 20 years antacids, and then H2 antagonists, have been the mainstays for protecting patients from stress bleeding. Recent evidence, however, questions the need for such therapy for most intensive care unit patients. Furthermore, increasing the intragastric pH may predispose patients to the development of nosocomial pneumonias, which carries a greater risk of mortality than does bleeding from stress ulcers. In patients who require gastric protection, sucralfate, which has no effect on gastric pH, is the preferred choice.
应激相关黏膜损伤出血是重症患者令人担忧的并发症。在过去20年里，抗酸剂，然后是H2拮抗剂，一直是保护患者预防应激性出血的主要药物。然而，最近的证据对大多数重症监护病房患者是否需要这种治疗提出了质疑。此外，提高胃内pH值可能使患者易患医院获得性肺炎，医院获得性肺炎的死亡风险比应激性溃疡出血更大。对于需要胃保护的患者，对胃pH值无影响的硫糖铝是首选。
