Adding proton pump inhibitors (PPIs) to endoscopic therapy has become the mainstay of treatment for peptic ulcer bleeding, with current consensus guidelines recommending high-dose intravenous (IV) PPI therapy (IV bolus followed by continuous therapy). However, whether or not high-dose PPI therapy is more effective than low-dose PPI therapy is still debated. Furthermore, maintaining pH >= 4 appears to prevent mucosal bleeding in patients with acute stress ulcers; thus, stress ulcer prophylaxis with acid-suppressing therapy has been increasingly recommended in intensive care units (ICUs). This review evaluates the evidence for the efficacy of IV pantoprazole, a PPI, in preventing ulcer rebleeding after endoscopic hemostasis, and in controlling gastric pH and protecting against upper gastrointestinal (GI) bleeding in high-risk ICU patients. The review concludes that IV pantoprazole provides an effective option in the treatment of upper GI bleeding, the prevention of rebleeding, and for the prophylaxis of acute bleeding stress ulcers.
机构:
VA Greater Los Angeles Healthcare Syst, CURE DDRC, Los Angeles, CA 90073 USAVA Greater Los Angeles Healthcare Syst, CURE DDRC, Los Angeles, CA 90073 USA
机构:
Natl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, TaiwanNatl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, Taiwan
Hsu, Ping-I
Lo, Gin-Ho
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Natl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, TaiwanNatl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, Taiwan
Lo, Gin-Ho
Lo, Ching-Chu
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Natl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, TaiwanNatl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, Taiwan
Lo, Ching-Chu
Lin, Chiun-Ku
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Natl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, TaiwanNatl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, Taiwan
Lin, Chiun-Ku
Chan, Hoi-Hung
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Natl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, TaiwanNatl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, Taiwan
Chan, Hoi-Hung
Wu, Chung-Jen
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Natl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, TaiwanNatl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, Taiwan
Wu, Chung-Jen
Shie, Chang-Bih
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Natl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, TaiwanNatl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, Taiwan
Shie, Chang-Bih
Tsai, Pei-Min
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Natl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, TaiwanNatl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, Taiwan
Tsai, Pei-Min
Wu, Deng-Chyang
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Kaohsiung Med Coll, Dept Internal Med, Div Gastroenterol, Kaohsiung, TaiwanNatl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, Taiwan
Wu, Deng-Chyang
Wang, Wen-Ming
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Kaohsiung Med Coll, Dept Internal Med, Div Gastroenterol, Kaohsiung, TaiwanNatl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, Taiwan
Wang, Wen-Ming
Lai, Kwok-Hung
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Natl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, TaiwanNatl Yang Ming Univ, Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung 813, Taiwan