What’s new with stress ulcer prophylaxis in the ICU?
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What is known?
Critically ill patients are at risk of stress-related mucosal erosions . These are typically superficial and asymptomatic but may progress to ulceration and overt and clinically important gastrointestinal (GI) bleeding, a serious condition associated with increased morbidity and mortality . The reported incidence of GI bleeding varies between 2 and 5% [3, 4], probably because of heterogeneous populations, varying definitions of GI bleeding, and difficulties in diagnosing stress ulcers [3, 4]. Importantly, stress ulcerations have been identified as the sole source of GI bleeding by endoscopy in fewer than 50% of patients with GI bleeding . A number of risk factors for stress ulcer-related bleedings have been suggested, including mechanical ventilation, coagulopathy, acute kidney injury, hepatic failure, and disease severity [2, 3, 4, 6]. A protective effect of enteral nutrition has been proposed , however this has not been confirmed in subsequent studies .
KeywordsIntensive Care Unit Intensive Care Unit Patient Clostridium Difficile Infection Lansoprazole Pantoprazole
Compliance with ethical standards
Conflicts of interest
The authors are members of the Steering Committee of the Stress Ulcer Prophylaxis in the Intensive Care Unit (SUP-ICU) trial. The authors declare no other conflicts of interest.
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