Biomedical subjects
J L DePriest
Publications and source records attributed to J L DePriest.
Stress ulcer prophylaxis. Do critically ill patients need it?
Critically ill patients who have a coagulopathy or require mechanical ventilation or high-dose corticosteroids are at increased risk for significant stress-related gastrointestinal hemorrhage. Unfortunately, it is not clear that prophylaxis has any impact on the incidence of bleeding or its outcome. When preventive therapy seems warranted, sucralfate (Carafate) is a good first choice if the patient has a nasoenteric tube in place. If not, histamine2 blockers in fixed doses by either continuous infusion or bolus can be used.
Septic shock. What to do until a breakthrough comes along.
Septic shock is a multisystem disorder that represents the host's response to microbial invasion in its most fulminant form. One of the critical defects is a widespread inability to use available substrate for energy production. Endogenous mediators, particularly the cytokines, appear to play an essential role in this defect and in the entire host-mediated cascade. Traditional therapy remains primarily supportive. However, newer, investigational forms of therapy show promise by more directly treating the underlying disturbances.