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19.09.2017 | Review Article

Stress Ulcer Prophylaxis in Neurocritical Care

verfasst von: Jeffrey F. Barletta, Alicia J. Mangram, Joseph F. Sucher, Victor Zach

Erschienen in: Neurocritical Care | Ausgabe 3/2018

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Abstract

Stress ulcer prophylaxis (SUP) with acid-suppressive drug therapy is widely utilized in critically ill patients following neurologic injury for the prevention of clinically important stress-related gastrointestinal bleeding (CIB). Data supporting SUP, however, largely originates from studies conducted during an era where practices were vastly different than what is considered routine by today’s standard. This is particularly true in neurocritical care patients. In fact, the routine provision of SUP has been challenged due to an increasing prevalence of adverse drug events with acid-suppressive therapy and the perception that CIB rates are sparse. This narrative review will discuss current controversies with SUP as they apply to neurocritical care patients. Specifically, the pathophysiology, prevalence, and risk factors for CIB along with the comparative efficacy, safety, and cost-effectiveness of acid-suppressive therapy will be described.
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Metadaten
Titel
Stress Ulcer Prophylaxis in Neurocritical Care
verfasst von
Jeffrey F. Barletta
Alicia J. Mangram
Joseph F. Sucher
Victor Zach
Publikationsdatum
19.09.2017
Verlag
Springer US
Erschienen in
Neurocritical Care / Ausgabe 3/2018
Print ISSN: 1541-6933
Elektronische ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-017-0447-y

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Ein pulverisierter Plastiklöffel im Gehirn

Das menschliche Gehirn besteht zu etwa 0,5% aus Nanoplastik — Tendenz weiter steigend. Nach Resultaten eine Autopsiestudie reichert sich Plastik im Gehirn 10- bis 30-fach stärker an als in anderen Organen — mit bislang noch völlig unklaren Folgen.

Schlaganfall durch wandernde A. carotis interna

Die Thrombolyse nützte nichts, vielmehr war eine Teilresektion des Zungenbeins nötig: Es hatte eine verlagerte Carotis interna komprimiert und so bei einem älteren Mann einen Schlaganfall ausgelöst. Per Bildgebung lässt sich eine solche Ursache manchmal nur schwer nachweisen.

Epileptischer Anfall nach Darmreinigung

Die Darmreinigung vor einer Koloskopie führte einen älteren Mann auf die Intensivstation: Seine Natriumwerte waren durch die Prozedur so gesunken, dass er Bewusstseinstrübungen und Krampfanfälle entwickelte.

Update Neurologie

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