Stress Ulcer Prophylaxis in the Intensive Care Unit: Effective, Safe, or Both?

Proton-pump inhibitors prevent gastrointestinal bleeding in critically ill patients and might limit mortality in less severely ill patients.

Critically ill patients are at risk for stress-induced gastrointestinal (GI) ulceration, which might cause clinically important upper GI bleeding. Proton-pump inhibitors (PPIs) can help prevent important upper GI bleeding and its consequences. To determine the efficacy and safety of pharmacologic prophylaxis, international investigators randomized 4821 mechanically ventilated patients in 68 intensive care units (ICUs) to pantoprazole (40 mg daily for 90 days or until extubation) or placebo. The same group then used data from this trial and 11 others to perform a patient-level meta-analysis.

In the randomized trial, pantoprazole significantly lowered the incidence of clinically important bleeding from 3.5% to 1% (number needed to treat to pre…

Reviewing Author

Raja-Elie E. Abdulnour, MD

Disclosures

Nothing to disclose

Raja-Elie E. Abdulnour, MD

Disclosures

Nothing to disclose

Stress Ulcer Prophylaxis in the Intensive Care Unit: Effective, Safe, or Both?

Topics

Reviewing Author