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Stress ulcer prophylaxis

Young Hwan Choi, Jong Ho Lee, Jae Jun Shin, Young Soon Cho
OBJECTIVE: Most of the literature about Curling's ulcer was published from 1960 through 1980. Therefore, an updated study of Curling's ulcer is needed. We analyzed the risk factors affecting ulcer incidence in burn patients. METHODS: We retrospectively analyzed the medical records of burn patients who were admitted to two burn centers. We collected information about the general characteristics of patients, burn area size, abbreviated burn severity index, whether surgery was performed, endoscopy results, and the total body surface area (TBSA)...
December 2015: Clin Exp Emerg Med
H M Steffen
The S2k-Guideline "Helicobacter pylori and gastroduodenal ulcer disease" offers a statement and comment on the subject of stress ulcer prophylaxis that need a critical response.
October 2016: Zeitschrift Für Gastroenterologie
John C O'Horo, Haitao Lan, Charat Thongprayoon, Louis Schenck, Adil Ahmed, Mikhail Dziadzko
OBJECTIVE Ventilator-associated events (VAEs) are nosocomial events correlated with length of stay, costs, and mortality. Current ventilator bundle practices target the older definition of ventilator-associated pneumonia and have not been systematically evaluated for their impact on VAEs. DESIGN Retrospective cohort study. SETTING Tertiary medical center between January 2012 and August 2014. PARTICIPANTS All adult patients ventilated for at least 24 hours at our institution. INTERVENTIONS We conducted univariate analyses for compliance with each element; we focused on VAEs occurring within a 2-day window of failure to meet any ventilator bundle element...
September 19, 2016: Infection Control and Hospital Epidemiology
Paul E Marik
No abstract text is available yet for this article.
October 2016: Critical Care Medicine
Shane P Selvanderan, Matthew J Summers, Mark E Finnis, Mark P Plummer, Yasmine Ali Abdelhamid, Michael B Anderson, Marianne J Chapman, Christopher K Rayner, Adam M Deane
OBJECTIVES: Pantoprazole is frequently administered to critically ill patients for prophylaxis against gastrointestinal bleeding. However, comparison to placebo has been inadequately evaluated, and pantoprazole has the potential to cause harm. Our objective was to evaluate benefit or harm associated with pantoprazole administration. DESIGN: Prospective randomized double-blind parallel-group study. SETTING: University-affiliated mixed medical-surgical ICU...
October 2016: Critical Care Medicine
Niloofar Rafinazari, Saeed Abbasi, Shadi Farsaei, Marjan Mansourian, Peyman Adibi
OBJECTIVE: Concern about adverse effects of the inconsistent use of stress-related mucosal damage prophylaxis in intensive care unit (ICU) is increasing. Hence, this study was designed to prospectively evaluate the rate of inappropriate stress ulcer prophylaxis (SUP) administration upon ICU admission, at ICU discharge and determine the adherence to American Society of Health-System Pharmacists (ASHP) guideline during ICU stay. METHODS: In this study, 200 patients were randomly selected from all ICU admissions during 9 months...
July 2016: Journal of Research in Pharmacy Practice
Michael Klompas, Lingling Li, Ken Kleinman, Paul M Szumita, Anthony F Massaro
IMPORTANCE: Ventilator bundles, including head-of-bed elevation, sedative infusion interruptions, spontaneous breathing trials, thromboprophylaxis, stress ulcer prophylaxis, and oral care with chlorhexidine gluconate, are ubiquitous, but the absolute and relative value of each bundle component is unclear. OBJECTIVE: To evaluate associations between individual and collective ventilator bundle components and ventilator-associated events, time to extubation, ventilator mortality, time to hospital discharge, and hospital death...
September 1, 2016: JAMA Internal Medicine
Jolie Gallagher, Alley J Killian, Craig M Coopersmith
No abstract text is available yet for this article.
July 2016: Critical Care Medicine
S P Selvanderan, M J Summers, M P Plummer, M E Finnis, Y Ali Abdelhamid, M B Anderson, M J Chapman, C K Rayner, A M Deane
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Aaron Larson, Sarah Ahrndt, Tarryn Jansen
No abstract text is available yet for this article.
April 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Nahla E El-Ashmawy, Eman G Khedr, Hoda A El-Bahrawy, Hend M Selim
Gastric ulcer is a very common gastrointestinal disease that may lead to dangerous complications and even death. This study was conducted to evaluate the prophylactic effect of nebivolol against indomethacin [INDO]-induced gastric ulcer. Male Wistar rats were divided into four groups: normal control, ulcer control (INDO only), omeprazole before INDO and nebivolol before INDO. Each rat to receive nebivolol and omeprazole was given the agent orally (by gavage) daily for 10 days prior to induction of ulcer by oral dosing with INDO...
July 2016: Journal of Immunotoxicology
Walavan Sivakumar, Heather S Spader, Eric Scaife, Robert J Bollo
The authors present the first case of a Cushing ulcer in an infant with medulloblastoma who, despite being administered stress ulcer prophylaxis, worsened after corticosteroids were initiated. An 8-month-old boy presented with progressive vomiting, lethargy, and decreased oral intake. Imaging revealed a heterogeneous fourth ventricular mass. Preoperatively, the patient was started on dexamethasone. The patient underwent an uncomplicated external ventricular drain placement and suboccipital craniotomy for resection of the lesion...
April 2016: Translational pediatrics
Jeffrey F Barletta, Jeffrey J Bruno, Mitchell S Buckley, Deborah J Cook
OBJECTIVES: Stress ulcer prophylaxis is commonly administered to critically ill patients for the prevention of clinically important stress-related mucosal bleeding from the upper gastrointestinal tract. Despite widespread incorporation of stress ulcer prophylaxis into practice around the world, questions are emerging about its indications and impact. This clinically focused article will review current controversies related to stress ulcer prophylaxis for critically ill adult patients, including bleeding frequency, risk factors, comparative efficacy, adverse effect profile, and overall cost-effectiveness of the available stress ulcer prophylaxis regimens...
July 2016: Critical Care Medicine
Farzaneh Foroughinia, Mohammad Madhooshi
OBJECTIVE: In this study, we aimed to evaluate the attachment to stress ulcer prophylaxis (SUP) guideline in the neurology wards of two teaching and nonteaching hospitals. METHODS: A total of 243 patients were retrospectively reviewed in the neurology wards of two teaching and nonteaching hospitals. To assess the appropriate administration of SUP, an internal guideline was prepared using the American Society of Health-System Pharmacists (ASHP) protocol. FINDINGS: SUP prescriptions were noncompliant with ASHP guideline in about 93...
April 2016: Journal of Research in Pharmacy Practice
Zhi-Kang Ye, Ying Liu, Xiang-Li Cui, Li-Hong Liu
BACKGROUND AND OBJECTIVE: Inappropriate use of stress ulcer prophylaxis (SUP) is common in many hospitals. High-quality clinical practice guidelines (CPGs) produce better patient outcomes and promote cost-effective clinical care. Thus, the objective of this study was to evaluate the quality of CPGs for SUP. METHODS: A search was conducted for SUP CPGs using PubMed, Embase, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature database (CBM), guideline websites and Google (until March 1, 2015)...
2016: PloS One
Fayez Alshamsi, Emilie Belley-Cote, Deborah Cook, Saleh A Almenawer, Zuhoor Alqahtani, Dan Perri, Lehana Thabane, Awad Al-Omari, Kim Lewis, Gordon Guyatt, Waleed Alhazzani
BACKGROUND: The relative efficacy and safety of proton pump inhibitors (PPIs) compared to histamine-2-receptor antagonists (H2RAs) should guide their use in reducing bleeding risk in the critically ill. METHODS: We searched the Cochrane library, MEDLINE, EMBASE, ACPJC, clinical trials registries, and conference proceedings through November 2015 without language or publication date restrictions. Only randomized controlled trials (RCTs) of PPIs vs H2RAs for stress ulcer prophylaxis in critically ill adults for clinically important bleeding, overt gastrointestinal (GI) bleeding, nosocomial pneumonia, mortality, ICU length of stay and Clostridium difficile infection were included...
May 4, 2016: Critical Care: the Official Journal of the Critical Care Forum
Mohammad A Y Alqudah, Sayer Al-Azzam, Karem Alzoubi, Mohammad Alkhatatbeh, Neda' Rawashdeh
OBJECTIVE: To determine the frequency of inappropriate proton pump inhibitor (PPI) prescriptions during hospitalization for stress ulcer prophylaxis on the general medical ward in a tertiary Jordanian hospital. MATERIALS AND METHODS: A retrospective chart review was executed on 236 patient admissions prescribed any PPI in a tertiary Jordanian hospital. For each patient, a detailed range of demographic and clinical variables was recorded. Patient's clinical variables were clustered into major vs...
August 2016: International Journal of Clinical Pharmacology and Therapeutics
Mette Krag, Anders Perner, Jørn Wetterslev, Matt P Wise, Mark Borthwick, Stepani Bendel, Paolo Pelosi, Frederik Keus, Anne Berit Guttormsen, Joerg C Schefold, Morten Hylander Møller
BACKGROUND: Critically ill patients in the intensive care unit (ICU) are at risk of clinically important gastrointestinal bleeding, and acid suppressants are frequently used prophylactically. However, stress ulcer prophylaxis may increase the risk of serious adverse events and, additionally, the quantity and quality of evidence supporting the use of stress ulcer prophylaxis is low. The aim of the SUP-ICU trial is to assess the benefits and harms of stress ulcer prophylaxis with a proton pump inhibitor in adult patients in the ICU...
2016: Trials
Rachael V McCaleb, Arpita S Gandhi, Stephen Michael Clark, Amber B Clemmons
BACKGROUND: Acid suppressive therapy (AST)-namely, proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs)-is routinely prescribed to hospitalized patients for stress ulcer prophylaxis (SUP). OBJECTIVE: To identify the incidence of and indications for AST use in the hematology/oncology population as well as to identify the occurrence of the following PPI-associated adverse events: pneumonia and Clostridium difficile-associated diarrhea (CDAD)...
July 2016: Annals of Pharmacotherapy
Vickie Larrow, Eira I Klich-Heartt
Ventilated-associated pneumonia (VAP) is a major concern for hospitals and a major problem for ventilated patients in the intensive care unit. Included in the basics are hand hygiene, wearing gloves, endotracheal tube suctioning, head of bed at 30°, stress ulcer prophylaxis, turning patient side to side at least every two hours, and giving the patient a sedation vacation each morning. Beyond the basics included here are oral hygiene, oral suctioning, endotracheal tube cuff pressure, artificial humidification, the difference in practice between registered nurses and respiratory therapists, using the beach chair position and early mobilization, and the VAP bundle...
June 2016: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
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