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

World Journal of Gastroenterology, 2025 · DOI: 10.3748/wjg.v31.i8.102959 · Published: February 28, 2025

Simple Explanation

Neurosurgical patients are at increased risk of stress ulcers due to conditions like brain injury and stroke. These ulcers can cause serious complications. The review discusses both medications and non-drug treatments to prevent these ulcers, such as PPIs and H2 antagonists as well as early feeding. The authors highlight the need for more research to determine the best ways to protect the gastrointestinal health of neurosurgical patients, including tailored approaches.

Study Duration

Not specified

Participants

Neurosurgical patients

Evidence Level

Level B-C, Editorial

Key Findings

1
Stress ulcers are a significant risk for neurosurgical patients, particularly those with severe brain injuries and elevated intracranial pressure.
2
Both pharmacological and non-pharmacological interventions are necessary for effective gastroprotection, but their routine use raises safety concerns.
3
There is a lack of comprehensive data on gastroprotection in critically ill neurosurgical patients, necessitating further investigation into optimal strategies.

Research Summary

Neurosurgical patients face a high risk of stress ulcers and gastrointestinal bleeding due to factors like brain injury, spinal cord injury, and increased intracranial pressure. The review discusses both pharmacological and non-pharmacological approaches to gastroprotection, highlighting the inconsistencies and controversies in current clinical practice. The authors emphasize the need for more high-quality research to evaluate gastroprotective strategies specifically tailored to neurocritical patients to improve outcomes and minimize complications.

Practical Implications

Personalized Gastroprotection

Tailoring gastroprotective strategies to the specific needs and risk factors of individual neurosurgical patients.

Balanced Approach

Integrating pharmacological and non-pharmacological interventions to optimize patient outcomes while minimizing potential risks.

Future Research

Conducting well-designed, large, randomized trials to address gaps in knowledge and standardize endpoint definitions.

Study Limitations

1
Lack of comprehensive data on gastroprotection in critically ill neurosurgical patients
2
Outdated studies forming the basis of current clinical practice guidelines
3
Inconsistencies in endpoint definitions across different studies

Your Feedback

Was this summary helpful?

Back to Critical Care