DOI: https://doi.org/10.14710/jai.v0i0.61232

Prevention and Management of Stress Ulcers in Critically ill Patients

Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Nursing and Public Health/ Gadjah Mada University, Dr. Sardjito Hospital, Yogyakarta, Indonesia

Received: 4 Jan 2024; Revised: 27 May 2024; Accepted: 27 May 2024; Available online: 16 Jul 2024.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)

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Abstract

Stress Ulcers or Stress Related Mucosal Damage (SRMD) is a term defining inflammation, erosion, and ulceration in upper gastrointestinal tract complicating patient with critical illness. Stress ulcers occurs because of imbalance between the aggressive factors on stomach (gastric acid, pepsin, and bile salt) and the defensive factors (mucous, bicarbonate, microcirculation, epithelial layer, and prostaglandin). The most common clinical feature of Stress Ulcers is upper gastrointestinal tract bleeding in which the incidence rate is 2,6% in critically ill patients. Stress ulcers commonly happened after a gastrointestinal mucosal break in 75 – 100% ICU patients in the first 24 hours of admission. The classification of stress ulcers including asymptomatic stress ulcers, stress ulcers with occult and overt bleeding, and stress ulcers with clinically significant gastrointestinal bleeding. The diagnosis of stress ulcers can be made by assumption only and do not need to do endoscopy. Some cases of stress ulcers that needed an endoscopy are patients with overt and clinically significant gastrointestinal bleeding stress ulcers. Thus, the treatment of stress ulcers is similar to upper gastrointestinal bleeding. Stress ulcers can be prevented by administering stress ulcers prophylaxissuch as Histamine H2 receptor antagonist, Proton Pump Inhibitor, cytoprotective agent (Sucralfate), and usage of enteral feeding method.

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Section: Literature Reviews
Language : EN
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