Infusion with proton pump inhibitors (PPIs) prevents recurrent bleeding after successful endoscopic therapy. A gastric acidic environment of less than pH 5.4 alters coagulation function and activates pepsin to disaggregate platelet plugs. Gastric acid is secreted by H +, K + -ATPase, naming the proton pump.

A randomized controlled trial (RCT) comparing a frequent oral PPI with an intravenous (IV) PPI showed that the former achieved 24‐h pH control similar to that of an IV bolus infusion, although the IV PPI reached a mean pH of 6 approximately 1 h sooner than oral PPI 18.

Intravenous (IV) proton-pump inhibitors (PPIs) are potent gastric acid suppressing agents, and their use is popular in clinical practice. Both IV and oral PPIs have similarly short half-lives, and their effects on acid secretion are similar, thus their dosing and dosage intervals appear to be interchangeable.

• Initial PO or IV bolus dose of PPI at 80mg ↓ the intragastric pH; especially in Western pts • IV PPI is more rapid onset • High dose PPI (i.e. ≥80mg daily) for ≥3 days continuously or intermittently after endoscopic tx ↓ further bleeding and mortality • UGIB due to high-risk ulcers who received endoscopic therapy

2017年2月23日 · Upper gastrointestinal bleeding remains a common reason for emergency department visits and is a major cause of morbidity, mortality, and medical care costs. Often when these patients arrive, the classic IV-O2-Monitor is initiated and hemodynamic stability is assessed.

Objectives: High-dose intravenous proton pump inhibitors (PPIs) post endoscopy are recommended in non-variceal upper gastrointestinal bleeding (UGIB), as they improve outcomes of patients with high-risk lesions. Determine the budget impact of using different PPI regimens in treating non-variceal UGIB, including pre- and post-endoscopic use ...

In clinically significant UGI bleeding, the primary goal is to restore the haemodynamic status, followed by early endoscopy. Intravenous octreotide in suspected variceal and PPI in non-variceal bleeding should be administered early. Stress ulcer prophylaxis should be restricted to …

2021年5月1日 · We performed systematic reviews addressing predefined clinical questions to develop recommendations with the GRADE approach regarding management of patients with overt upper gastrointestinal bleeding.

Patients who, at endoscopy, are found to have a peptic ulcer deemed to be at high risk of re-bleeding; these are actively bleeding ulcers or non-bleeding ulcers with a visible vessel. These patients should be given intravenous omeprazole 40mg BD for 72 hours, of which the first dose should be prescribed stat.

It is standard practice to start patients with undifferentiated UGIB on acid suppression therapy with an intravenous proton-pump inhibitor (PPI) in the emergency department prior to admission or endoscopy.2 This practice is based on data that the most common cause of UGIB is …