science review the use of proton pump inhibitors for gastric acid suppression in critical illness科学审查的使用质子泵抑制剂抑制胃酸的重要疾病.pdfVIP

Available online /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, stephen.brett@imperial.ac.uk Published online: 8 October 2004 Critical Care 2005, 9:45-50 (DOI 10.1186/cc2980) This article is online at /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 (H RAs). The H RAs are currently the most 2 2 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 mul