Gastrointestinal Bleeding Following Head Injury

KAMADA, T.; Fusamoto, Hideyuki; Kawano, Seiji; Noguchi, Masafumi; Hiramatsu, Kosuke; Masuzawa, Manabu; Abe, Hisashi; Fujii, Chiiho; Sugimoto, Tomoyuki

doi:10.1097/00005373-197701000-00006

Cited by 87 publications

(33 citation statements)

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“…Cushing’s ulcers, often deep, are found in the duodenum, stomach or esophagus. They are associated with hypergastrinemia and acid hypersecretion, which may account for the different distribution and appearance of Cushing’s ulcers, as well as their increased tendency for bleeding [6,7,8,9]. In ICU ulcer cases, time-dependent changes of the mucosa found by endoscopy have been reported.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic Ulcers after Great East Japan Earthquake and Tsunami: Features of Post-Disaster Hemorrhagic Ulcers

Kanno¹,

Iijima²,

Abe³

et al. 2013

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Background: We investigated the characteristic features and treatment of hemorrhagic peptic ulcers after the Great East Japan Earthquake, which occurred on 11 March 2011. Methods: Clinical data of patients with hemorrhagic peptic ulcers were retrospectively collected during the 3 months after the earthquake from seven major hospitals in the middle of the stricken area, and were compared with those during the same period of the previous year. Results: After the earthquake, the number of hemorrhagic ulcers increased 2.2 fold as compared with the previous year, and gastric ulcers were significantly more frequent compared with duodenal ulcers (p <0.05) and more often presented multiple forms (p <0.05). Nonetheless, the proportion of re-bleeding cases after hemostasis treatment (8% in 2010 vs. 5% in 2011) or total mortality rate (2.5% in 2010 vs. 1.2% in 2011) was rather lower after the earthquake compared with that of the previous year. Conclusion: We clarified that post-disaster hemorrhagic ulcers existed frequently in the stomach, often as multiple ulcers at the same time. The Great East Japan Earthquake and Tsunami caused many cases of hemorrhagic ulcer. However, because of the high success rate of endoscopic hemostasis, the mortality remained as low as in the previous year. Our present study provides important information for large-scale disasters which can occur anywhere.

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Section: Discussionmentioning

confidence: 99%

Hemorrhagic Ulcers after Great East Japan Earthquake and Tsunami: Features of Post-Disaster Hemorrhagic Ulcers

Kanno¹,

Iijima²,

Abe³

et al. 2013

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“…This was because we did not collect in the RCT any international normalized ratio or partial thromboplastin time values. However, in the univariate analysis of the post-RCT observational study thrombocytopenia was significantly associated with bleeding; considering this and other evidence [37,38,39], coagulopathy and mechanical ventilation remain the two major risk factors for gastrointestinal bleeding.…”

Section: Discussionmentioning

confidence: 96%

On the need for observational studies to design and interpret randomized trials in ICU patients: a case study in stress ulcer prophylaxis

2001

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“…Respiratory failure requiring mechanical ventilation for more than 48 h Coagulopathy (international normalized ratio more than 1.5 or platelet count less than 50,000 platelet/ll) Acute renal insufficiency 16:184-193 185 injury, irrespective of the presence or absence of other risk factors [15].…”

Section: Pathophysiology and Risk Factorsmentioning

confidence: 99%

Gastrointestinal Prophylaxis in Neurocritical Care

et al. 2011

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The aim of this study is to review and summarize the relevant literature regarding pharmacologic and non-pharmacologic methods of prophylaxis against gastrointestinal (GI) stress ulceration, and upper gastrointestinal bleeding in critically ill patients. Stress ulcers are a known complication of a variety of critical illnesses. The literature regarding epidemiology and management of stress ulcers and complications thereof, is vast and mostly encompasses patients in medical and surgical intensive care units. This article aims to extrapolate meaningful data for use with a population of critically ill neurologic and neurosurgical patients in the neurological intensive care unit setting. Studies were identified from the Cochrane Central Register of controlled trials and NLM PubMed for English articles dealing with an adult population. We also scanned bibliographies of relevant studies. The results show that H(2)A, sucralfate, and PPI all reduce the incidence of UGIB in neurocritically ill patients, but H(2)A blockers may cause encephalopathy and interact with anticonvulsant drugs, and have been associated with higher rates of nosocomial pneumonias, but causation remains unproven and controversial. For these reasons, we advocate against routine use of H(2)A for GI prophylaxis in neurocritical patients. There is a paucity of high-level evidence studies that apply to the neurocritical care population. From this study, it is concluded that stress ulcer prophylaxis among critically ill neurologic and neurosurgical patients is important in preventing ulcer-related GI hemorrhage that contributes to both morbidity and mortality. Further, prospective trials are needed to elucidate which methods of prophylaxis are most appropriate and efficacious for specific illnesses in this population.

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Gastrointestinal Bleeding Following Head Injury

Cited by 87 publications

References 0 publications

Hemorrhagic Ulcers after Great East Japan Earthquake and Tsunami: Features of Post-Disaster Hemorrhagic Ulcers

Hemorrhagic Ulcers after Great East Japan Earthquake and Tsunami: Features of Post-Disaster Hemorrhagic Ulcers

On the need for observational studies to design and interpret randomized trials in ICU patients: a case study in stress ulcer prophylaxis

Gastrointestinal Prophylaxis in Neurocritical Care

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