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Revista Colombiana de Gastroenterologia

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FARFAN QUEVEDO, Yezid Alfonso et al. Upper digestive bled in intensive cares. Rev Col Gastroenterol [online]. 2006, vol.21, n.2, pp.131-138. ISSN 0120-9957.

In the last decades the frequency of the digestive bled in UCI has been increased, particularly in those patients who require mechanical ventilation. From 1960 one has been to explain the involved physiopatogenic mechanisms in the digestive bled in UCI; also like determining the most suitable prophylaxis and the best treatment of this complication (1). Most of the critically ill patients develop injury of gastric mucosa so soon they enter the unit of intensive cares (UCI). Numerous factors of risk have been identified that prearrange to the hemorrhage of high digestive routes in patient the critically ill one, as they are the mechanical ventilation by but of 48 hours, coagulation disorders , severe sepsis, cranial trauma, severe neurosurgery, burns and fails organic manifold (1). Although controversial, the infection by H Pylori also has been related like factor of bled risk for digestive in UCI (5). It has been tried to prevent the patient HVDA in the critically ill one by means of the use with different pharmacologic agents as they are the antacid medicines, the antagonists of histamine the H2 receivers and the inhibitors of proton pump. Nevertheless, until the moment there is no a general consensus of as of them it does not have to be used, like of the route of administration being used either. Another disadvantage is to differentiate if the digestive bled one is clinically important because the boarding and unties is different (2). The therapy with antagonists of histamine H2 receivers has shown to diminish the incidence of HVDA in critically ill patients in the United States and have been approved by the FDA for bled prophylaxis of in UCI. The single present evidence allows to suppose us that the inhibitors of proton pump are as effective as the antagonists of the H2 receivers in the prevention of the patient digestive bled one in the critically ill one in UCI, but not yet we know if they are superior (1, 2, 6).

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