Does antacid prophylaxis prevent upper gastrointestinal bleeding in critically ill patients?

Pinilla, Jaime C.; Oleniuk, Fredrick H.; Reed, Diane Moniz; Malik, Bharat; Laverty, W. H.

doi:10.1097/00003246-198508000-00007

Cited by 63 publications

(3 citation statements)

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“…We performed a meta‐analysis of 30 RCTs. 984 , 985 , 986 , 987 , 988 , 989 , 990 , 991 , 992 , 993 , 994 , 995 , 996 , 997 , 998 , 999 , 1000 , 1001 , 1002 , 1003 , 1004 , 1005 , 1006 , 1007 , 1008 , 1009 , 1010 , 1011 , 1012 , 1013 The estimated values of desirable anticipated effects were as follows: gastrointestinal bleeding yielded a RD of 44 fewer per 1,000 (95%CI: 54 fewer to 28 fewer) (14 RCTs, n = 4,884); mortality yielded an RD of 3 more per 1,000 (95%CI: 22 fewer to 33 more) (8 RCTs, n = 4,314). Meanwhile, the estimated values of the undesirable anticipated effects were as follows: pneumonia yielded an RD of 4 more per 1,000 (95%CI: 16 fewer to 28 more) (8 RCTs, n = 4,286); Clostridioides infection yielded an RD of 4 fewer per 1,000 (95%CI: 9 fewer to 5 more) (3 RCTs, n = 3,607); various serious adverse effects yielded an RD of 5 more per 1,000 (95%CI: 6 fewer to 20 more) (7 RCTs, n = 4,143).…”

Section: Methods Used For Creating This Guidelinementioning

confidence: 99%

“…We performed a meta‐analysis of 30 RCTs 984–1013 . The estimated values of desirable anticipated effects were as follows: gastrointestinal bleeding yielded a RD of 44 fewer per 1,000 (95%CI: 54 fewer to 28 fewer) (14 RCTs, n = 4,884); mortality yielded an RD of 3 more per 1,000 (95%CI: 22 fewer to 33 more) (8 RCTs, n = 4,314).…”

Section: Methods Used For Creating This Guidelinementioning

confidence: 99%

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The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J‐SSCG 2020)

Egi

Ogura

Yatabe

et al. 2021

Acute Medicine & Surgery

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The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J‐SSCG 2020), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created as revised from J‐SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high‐quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J‐SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU‐acquired weakness [ICU‐AW], post‐intensive care syndrome [PICS], and body temperature management). The J‐SSCG 2020 covered a total of 22 areas with four additional new areas (patient‐ and family‐centered care, sepsis treatment system, neuro‐intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large‐scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members. As a result, 79 GRADE‐based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J‐SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines.

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Section: Methods Used For Creating This Guidelinementioning

confidence: 99%

Section: Methods Used For Creating This Guidelinementioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J‐SSCG 2020)

Egi

Ogura

Yatabe

et al. 2021

Acute Medicine & Surgery

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show abstract

“…Etiology and pathophysiology of SRMD are multifactorial and have not been fully clear, but impairment of mucosal protective mechanisms and raising of the acid product play significant roles [2]. The recommendation is based on studies, prophylaxis process for suppuration of gastric acid with histamine-2 receptor antagonist or PPIs therapy significantly reduced the risk of GI bleeding in critically ill patients [3][4][5][6][7]. SRP with histamine-2 (H2) Antagonist, Sucralfate or proton pump inhibitors (PPIs) reduce the incidence of gastrointestinal bleeding by 29%-61 [6,7].…”

Section: Introductionmentioning

confidence: 99%

Survey on the Prevalence of Intravenous Use of Proton Pump Inhibitors and H2-antagonists in Internal Medicine Ward

Fallahzade¹,

Aliabadi²

2019

JPRI

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Background: Anti-acids drugs are commonly used for stress ulcer prophylaxis (SUP). Some inpatients receiving acid suppression therapy without risk factors for nosocomial upper gastrointestinal bleeding and this inappropriate usage increase time, costs and avoidable side effects such as hospital-acquired pneumonia. Purpose: This study was designed to evaluate the prevalence of stress ulcer prophylactic drugs use, the number of properly indicated administrations and prescription prevalence of intravenous use of proton pump inhibitors (PIPs) and H2-antagonists in preventing nosocomial gastrointestinal bleeding and pneumonia. Methods: This cross-sectional study was performed on 280 patients in two different time zone before and after implementing of guidelines for SUP usage on the medical service in January and March of 2014(pre-intervention period) and January and march of 2015 (post-intervention period). Indicated anti-acid therapy for stress ulcer prophylaxis was defined according to the 1999 American Society of Health-System Pharmacists (ASHP) guidelines for the use of SUP. The Patient’s data such as kind of stress ulcer prophylaxis drug, ICU admission and the indication of prophylaxis pre and post-intervention were collected. Data were analyzed by SPSS software using the Pearson Chi-square test and unpaired t-test. Results: There was no significant change in the administration of stress ulcer prophylaxis drugs in general, but anti-acid medications misused decreased from 63.6% to 55.2% after intervention. Conclusion: The use of anti-acids without proper indication had 11.4% fall. The IV administration had a dramatic decrease as opposed to PO anti-acids use, which had a significant effect on hospital financial costs. In the end, there was no significant change detected in the total use of SUP (stress ulcer prophylaxis).

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Prophylaxis of Upper Gastrointestinal Tract Bleeding in Mechanically Ventilated Patients

Cannon

Heiselman²,

Gardner³

et al. 1987

Arch Intern Med

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Does antacid prophylaxis prevent upper gastrointestinal bleeding in critically ill patients?

Cited by 63 publications

References 0 publications

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J‐SSCG 2020)

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J‐SSCG 2020)

Survey on the Prevalence of Intravenous Use of Proton Pump Inhibitors and H2-antagonists in Internal Medicine Ward

Prophylaxis of Upper Gastrointestinal Tract Bleeding in Mechanically Ventilated Patients

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