Details

Autor(en) / Beteiligte

• Lau, James Y
• Leung, Wai K
• Wu, Justin C.Y
• Chan, Francis K.L
• Wong, Vincent W.S
• Chiu, Philip W.Y
• Lee, Vivian W.Y
• Lee, Kenneth K.C
• Cheung, Frances K.Y
• Siu, Priscilla
• Ng, Enders K.W
• Sung, Joseph J.Y

Titel

Omeprazole before Endoscopy in Patients with Gastrointestinal Bleeding

Ist Teil von

• The New England journal of medicine, 2007-04, Vol.356 (16), p.1631-1640

Ort / Verlag

Boston, MA: Massachusetts Medical Society

Erscheinungsjahr

2007

Quelle

MEDLINE

Beschreibungen/Notizen

• In this randomized study of patients with upper gastrointestinal bleeding, infusion of omeprazole, as compared with placebo, before endoscopy reduced the incidence of endoscopic treatment (19.1% vs. 28.4%, P=0.007) and, among patients with peptic ulcers, resulted in fewer actively bleeding ulcers and more ulcers with clean bases. These findings suggest that infused omeprazole is beneficial for patients with upper gastrointestinal bleeding who are awaiting endoscopy. In patients with upper gastrointestinal bleeding, infusion of omeprazole before endoscopy reduced the incidence of endoscopic treatment (19.1% vs. 28.4%) and, among patients with peptic ulcers, resulted in fewer actively bleeding ulcers and more ulcers with clean bases. In patients with bleeding peptic ulcers, we previously showed that infusion of a high-dose proton-pump inhibitor after hemostasis had been achieved during endoscopy reduced recurrent bleeding and improved clinical outcomes. 1 The adjuvant use of high-dose proton-pump inhibitors in endoscopic therapy has also been endorsed in two consensus statements 2 , 3 and confirmed in two meta-analyses. 4 , 5 Clot formation over arteries is pH dependent; a gastric pH above 6 is thought to be critical for platelet aggregation. 6 When given intravenously and at a high dose, proton-pump inhibitors can be used to maintain a neutral gastric pH. 7 In clinical practice, treatment with proton-pump . . .