Do all patients need to prevent stress-erosive lesions of the gastrointestinal tract?

August 30, 2017
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There was analyzed the literature data on the state of the problem of preventing stress-erosive damage of the gastrointestinal tract mucosa in critically ill patients. It was found that almost 100% of patients undergo stressful changes in the mucous membrane of the gastrointestinal tract, which can be complicated by clinically significant intestinal bleeding in 5–15% of cases. Mortality of patients in the incidence of bleeding is up to 50%, therefore medical prevention of stress erosion and possible further bleeding with antisecretory drugs is usually used. The effectiveness of the drug prevention of stress bleeding in critical patients is debated, but the overwhelming majority of researchers recommended the identification of risk factors for the development of adverse complications of stress erosion and the appointment of preventive therapy in setting high risk. The most used for the prevention of bleeding from stress erosions are proton pump inhibitors for their potent antisecretory activity. Rabeprazole, which is characterized by reliable efficacy in increasing the pH of gastric contents and a high safety profile, deserves separate attention.