Effect of Gastric Cold Irrigation on Stress Ulceration

Zavagno, G.; Khan, Ibrar; Moschin, Nicoletta; Pasqual, Enrico Maria; Cagol, Pier Paolo; Lise, Mario

doi:10.1159/000128740

Cited by 2 publications

(4 citation statements)

References 8 publications

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“…The energy demand of the cell (the necessary blood supply) is not an independent factor but is directly related to the metabolic rate. If the stomach is cooled under normal conditions, the effect on the mucosal blood supply is clearly greater than the reduction of the metabolic rate resulting in an energy deficit with subsequent mucosal lesions (13,16). The effect is quite different under shock conditions, however.…”

Section: Gastric Lavagementioning

confidence: 99%

“…The ice-water lavage in the case of bleeding ulcers and non stress-related lesions has, in fact, failed to bring any convincing success. However, the prevailing conditions in Local and medicinal measures are the main therapy for acute the case of the ICU patient with stress bleeding, particularly with regard to the mucosal blood supply, are quite different from those in the patient with an ulcer disease, drug-induced gastritis, or in experimental models (6,7,9,13). Cooling of the gastric mucosa leads to vasoconstriction and thus to ischemia (7).…”

Section: Gastric Lavagementioning

confidence: 99%

“…Thus, the net effect of the ice-water lavage in severely ill ICU patients is to reestablish the balance between energy supply and demand. This hypothesis has been investigated in an experimental model (13). proving that only under stress conditions is ice lavage effective in the cessation of acute bleeding (Fig.…”

Section: Gastric Lavagementioning

confidence: 99%

“…Frequency and severity of gastric lesions under normal conditions and in animals with hemorrhagic shock in relation to the temperature of the gastric lavage(13).…”

mentioning

confidence: 99%

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Conservative Treatment of Stress Ulcer Bleeding: A New Approach

Tryba¹,

May²

1992

Scandinavian Journal of Gastroenterology

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Tryba M, May B. Conservative treatment of stress ulcer bleeding: a new approach. Scand J Gastroenterol 1992;27 Suppl 191:1624. Stress ulcer prophylaxis diminishes but does not eliminate the risk of severe bleeding from this complication. In 7040% of the cases the source qf bleeding is hemorrhagic gastritis. No controlled studies exist which have in particular investigated conservative therapy in patients with stress-induced hemorrhage. Even effective measures to suppress gastric acid secretion or to reduce splanchnic blood flow are ineffective in 1040% of intensive care unit patients with stress-induced bleeding. In these cases total gastrectomy has so far often been the only therapeutic approach. We report our experience with a new approach in treating severe stress-induced hemorrhagic gastritis after ineffective primary treatment with HTreceptor antagonists, pirenzepine and somatostatin. Continuous gastric lavage with 5-10 I ice-cold Ringer's solution was used until complete cessation of bleeding. as evident from clear lavage. Repeated administration of 12 g sucralfate (60 ml) at 2-h intervals for 24 h through a gastric tube was hsed to prevent recurrence of bleeding and to promote healing. Sucralfate was reduced on the 2nd and 3rd day to 20 ml 2-hourly and later to 10 ml 4-hourly. In four patients this treatment was used as an ultima ratio when the patients were already scheduled for total gastrectomy. A total of 23 patients were treated during a 7-year period; all of them responded successfully, and no patient required surgery. Scand J Gastroenterol Downloaded from informahealthcare.com by Indiana University on 12/13/14 For personal use only. Scand J Gastroenterol Downloaded from informahealthcare.com by Indiana University on 12/13/14 For personal use only.

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Section: Gastric Lavagementioning

confidence: 99%

Section: Gastric Lavagementioning

confidence: 99%

Section: Gastric Lavagementioning

confidence: 99%

“…Frequency and severity of gastric lesions under normal conditions and in animals with hemorrhagic shock in relation to the temperature of the gastric lavage(13).…”

mentioning

confidence: 99%

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