关键词: Anticoagulantes Anticoagulants Antiinflamatorios no esteroideos Aspirin Gastrointestinal bleeding Hemorragia gastrointestinal Inhibidor de la bomba de protons Non-steroidal anti-inflammatory drugs Peptic ulcer Proton pump inhibitor Ácido acetilsalicílico Úlcera péptica

Mesh : Anti-Inflammatory Agents, Non-Steroidal Aspirin Gastrointestinal Hemorrhage / etiology therapy Humans Peptic Ulcer Peptic Ulcer Hemorrhage Proton Pump Inhibitors

来  源:   DOI:10.1016/S0210-5705(16)30175-3

Abstract:
The main innovations of the latest meeting of the Gastroenterological Association (2016) concerning upper gastrointestinal bleeding from the clinician\'s perspective can be summarised as follows: a) The Glasgow-Blatchford scale has the best accuracy in predicting the need for surgical intervention and hospital mortality; b) Prognostic scales for non-variceal upper gastrointestinal bleeding are also useful for lower gastrointestinal bleeding; c) Preliminary data suggest that treatment with hemospray does not seem to be superior to current standard treatment in controlling active peptic ulcer bleeding; d) Either famotidine or a proton pump inhibitor may be effective in preventing haemorrhagic recurrence in patients taking aspirin, but this finding needs to be confirmed in further studies; e) There was confirmation of the need to re-introduce antiplatelet therapy as early as possible in patients with antiplatelet-associated gastrointestinal bleeding in order to prevent cardiovascular mortality; f) Routine clinical practice suggests that gastrointestinal or cardiovascular complications with celecoxib or traditional NSAIDs are very low; g) Dabigatran is associated with an increased incidence of gastrointestinal bleeding compared with apixaban or warfarin. At least half of the episodes are located in the lower gastrointestinal tract; h) Implant devices for external ventricular circulatory support are associated with early gastrointestinal bleeding in up to one third of patients; the bleeding is often secondary to arteriovenous malformations.
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