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Use of β-blocker therapy to prevent primary bleeding of esophageal varices.
J Am Acad Nurse Pract. 2010 Dec; 22(12):640-7.JA

Abstract

PURPOSE

The purpose of this article is to educate nurse practitioners about the pathophysiology surrounding the development of portal hypertension and the effective use of nonselective β-blockers to prevent primary bleeding and decrease the mortality risk.

DATA SOURCES

The articles included were retrieved via ISI Web of Science using the years 2004-2009 and key words cirrhosis, portal hypertension, esophageal varices, and beta-blockers. This information included scholarly books, journal reviews, retrospective chart reviews, and prospective randomized studies.

CONCLUSIONS

Cirrhosis is the leading cause of portal hypertension in Europe and North America. Esophageal varices are a result of the portosystemic collaterals the body develops to decompress the portal system. Hemorrhage from esophageal varices is a major cause of morbidity and mortality. Prevention of a primary bleed is the goal of therapy and is accomplished with nonselective β-blockers.

IMPLICATIONS FOR PRACTICE

Very few patients with portal hypertension and esophageal varices are on β-blockers. Use of nonselective β-blockers has been found to lower portal pressure and decreases the risk of bleeding from esophageal varices and therefore decreases mortality. Patients unable to use β-blockers can undergo endoscopic variceal ligation as an alternate method to reduce risk of bleeding.

Authors+Show Affiliations

Endoscopy Department, Hospital of the University of Pennsylvania, Philadelphia, USA. tammy.tursi@uphs.upenn.edu

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21129071

Citation

Tursi, Tammy. "Use of SS-blocker Therapy to Prevent Primary Bleeding of Esophageal Varices." Journal of the American Academy of Nurse Practitioners, vol. 22, no. 12, 2010, pp. 640-7.
Tursi T. Use of β-blocker therapy to prevent primary bleeding of esophageal varices. J Am Acad Nurse Pract. 2010;22(12):640-7.
Tursi, T. (2010). Use of β-blocker therapy to prevent primary bleeding of esophageal varices. Journal of the American Academy of Nurse Practitioners, 22(12), 640-7. https://doi.org/10.1111/j.1745-7599.2010.00567.x
Tursi T. Use of SS-blocker Therapy to Prevent Primary Bleeding of Esophageal Varices. J Am Acad Nurse Pract. 2010;22(12):640-7. PubMed PMID: 21129071.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of β-blocker therapy to prevent primary bleeding of esophageal varices. A1 - Tursi,Tammy, Y1 - 2010/11/09/ PY - 2010/12/7/entrez PY - 2010/12/7/pubmed PY - 2011/4/2/medline SP - 640 EP - 7 JF - Journal of the American Academy of Nurse Practitioners JO - J Am Acad Nurse Pract VL - 22 IS - 12 N2 - PURPOSE: The purpose of this article is to educate nurse practitioners about the pathophysiology surrounding the development of portal hypertension and the effective use of nonselective β-blockers to prevent primary bleeding and decrease the mortality risk. DATA SOURCES: The articles included were retrieved via ISI Web of Science using the years 2004-2009 and key words cirrhosis, portal hypertension, esophageal varices, and beta-blockers. This information included scholarly books, journal reviews, retrospective chart reviews, and prospective randomized studies. CONCLUSIONS: Cirrhosis is the leading cause of portal hypertension in Europe and North America. Esophageal varices are a result of the portosystemic collaterals the body develops to decompress the portal system. Hemorrhage from esophageal varices is a major cause of morbidity and mortality. Prevention of a primary bleed is the goal of therapy and is accomplished with nonselective β-blockers. IMPLICATIONS FOR PRACTICE: Very few patients with portal hypertension and esophageal varices are on β-blockers. Use of nonselective β-blockers has been found to lower portal pressure and decreases the risk of bleeding from esophageal varices and therefore decreases mortality. Patients unable to use β-blockers can undergo endoscopic variceal ligation as an alternate method to reduce risk of bleeding. SN - 1745-7599 UR - https://www.unboundmedicine.com/medline/citation/21129071/Use_of_β_blocker_therapy_to_prevent_primary_bleeding_of_esophageal_varices_ L2 - https://doi.org/10.1111/j.1745-7599.2010.00567.x DB - PRIME DP - Unbound Medicine ER -