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.
DePriest
J L
JL
Medical Intensive Care Unit, Fitzsimons Army Medical Center, Aurora, Colorado, USA.
D000897:Anti-Ulcer Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D016638:Critical Illness; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D010437:Peptic Ulcer / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors; D013312:Stress, Physiological
D000897:Anti-Ulcer Agents