Mind the gut:Navigating the complex landscape of gastroprotection in neurosurgical patients  

作　　者：Subeikshanan Venkatesan Brandon Lucke-Wold 

机构地区：[1]Department of Neurosurgery,University of Flordia,Gainesville,FL 32608,United States

出　　处：《World Journal of Gastroenterology》2025年第8期1-8,共8页世界胃肠病学杂志(英文)

摘　　要：Neurosurgical patients,including those with severe traumatic brain injury,spinal cord injury,stroke,or raised intracranial pressure,are at heightened risk for stress ulcers and aspiration pneumonitis,leading to significant morbidity and mortality.These patients are typically managed through both pharmacological interventions[e.g.,proton pump inhibitors(PPIs),histamine 2(H2)antagonists,sucralfate]and non-pharmacological measures(e.g.,nasogastric decompression,patient positioning)to mitigate adverse outcomes.The pathogenesis of stress ulcers in neurosurgical patients is multifactorial,but the routine use of stress ulcer prophylaxis remains controversial.While gastric acid suppression with H2 rece-ptor antagonists and PPIs is commonly employed,concerns have arisen regarding the association between elevated gastric pH,bacterial colonization,and ventilator-associated pneumonia.The lack of comprehensive data on gastroprotection in critically ill neurosurgical patients,who face a greater risk than non-neurosurgical counterparts,further complicates this issue.Recent studies,such as one by Gao et al on the efficacy of vonoprazan-amoxicillin dual therapy in elderly patients,highlight the potential of novel therapies,but the influence of pre-existing conditions like Helicobacter pylori infection remains unclear.Non-pharmacological interventions,including nasogastric decompression and early enteral nutrition,are critical in improving outcomes but require further research to refine strategies.This editorial underscores the need for tailored approaches and encourages further investigation into optimal gastroprotective strategies for neurosurgical patients.

关 键 词：GASTROPROTECTION NEUROSURGERY Stress ulcer Proton pump inhibitor Histamine 2 receptor antagonist Vonoprazan Nasogastric tube Enteral nutrition 

分 类 号：R57[医药卫生—消化系统]