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Stress ulcer prophylaxis

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https://www.readbyqxmd.com/read/28646925/stress-ulcer-prophylaxis-versus-placebo-or-no-prophylaxis-in-adult-hospitalised-acutely-ill-patients-protocol-for-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#1
Søren Marker, Anders Perner, Jørn Wetterslev, Marija Barbateskovic, Janus Christian Jakobsen, Mette Krag, Anders Granholm, Carl Thomas Anthon, Morten Hylander Møller
BACKGROUND: Stress ulcer prophylaxis is considered standard of care in many critically ill patients in the intensive care unit (ICU). However, the quality of evidence supporting this has recently been questioned, and clinical equipoise exists. Whether there is overall benefit or harm of stress ulcer prophylaxis in adult hospitalised acutely ill patients is unknown. Accordingly, we aim to assess patient-important benefits and harms of stress ulcer prophylaxis versus placebo or no treatment in adult hospitalised acutely ill patients with high risk of gastrointestinal bleeding irrespective of hospital setting...
June 24, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28622739/impact-of-a-collaborative-strategy-to-reduce-the-inappropriate-use-of-acid-suppressive-therapy-in-non-intensive-care-unit-patients
#2
Kristen D Belfield, Arpi G Kuyumjian, Rafael Teran, Mariette Amadi, Melissa Blatt, Keri Bicking
BACKGROUND: Stress ulcer prophylaxis (SUP) is inappropriately prescribed in more than 30% of non-intensive care unit (ICU) patients, leading to unnecessary adverse events as well as increases in economic burden. OBJECTIVE: There was an increasing trend in the prophylactic use of acid suppressive therapy (AST) in non-critically ill patients at our institution, which prompted this initiative aimed at reducing the inappropriate use of AST in non-ICU patients. METHODS: This was a retrospective interventional study that consisted of formulation of a guideline, education to the hospitalist service, and intervention by clinical pharmacists...
July 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28622218/stress-ulcer-prophylaxis-friend-or-foe
#3
Mette Krag, Morten Hylander Møller
No abstract text is available yet for this article.
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28608496/stress-ulcer-prophylaxis-in-the-intensive-care-unit-trial-detailed-statistical-analysis-plan
#4
M Krag, A Perner, J Wetterslev, T Lange, M P Wise, M Borthwick, S Bendel, P Pelosi, F Keus, A B Guttormsen, J C Schefold, T S Meyhoff, S Marker, M H Møller
BACKGROUND: In this statistical analysis plan, we aim to provide details of the pre-defined statistical analyses of the Stress Ulcer Prophylaxis in the Intensive Care Unit (SUP-ICU) trial. The aim of the SUP-ICU trial is to assess benefits and harms of stress ulcer prophylaxis with a proton pump inhibitor in adult patients in the intensive care unit (ICU). METHODS: The SUP-ICU trial is an investigator-initiated, international, multicentre, randomised, blinded, parallel-group trial of intravenously pantoprazole 40 mg once daily vs...
June 12, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28572098/prophylactic-acid-suppressive-therapy-in-hospitalized-adults-indications-benefits-and-infectious-complications
#5
Andrew C Faust, Kelly L Echevarria, Rebecca L Attridge, Lyndsay Sheperd, Marcos I Restrepo
Acid-suppressive therapy for prophylaxis of stress ulcer bleeding is commonly prescribed for hospitalized patients. Although its use in select, at-risk patients may reduce clinically significant gastrointestinal bleeding, the alteration in gastric pH and composition may place these patients at a higher risk of infection. Although any pharmacologic alteration of the gastric pH and composition is associated with an increased risk of infection, the risk appears to be highest with proton pump inhibitors, perhaps owing to the potency of this class of drugs in increasing the gastric pH...
June 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28533916/pediatric-intensive-care-stress-ulcer-prevention-pic-up-a-protocol-for-a-pilot-randomized-trial
#6
Mark Duffett, Karen Choong, Jennifer Foster, Elaine Gilfoyle, Jacques Lacroix, Nikhil Pai, Lehana Thabane, Deborah J Cook
BACKGROUND: Despite sparse pediatric data on effectiveness, the majority of critically ill children receive medications to prevent gastrointestinal (GI) bleeding. Stress ulcer prophylaxis may have unintended consequences-increasing the risk of nosocomial infections-which may be more serious and common than the bleeding which these drugs are prescribed to prevent. Randomized controlled trials (RCTs) in pediatric critical care are exceptionally challenging to complete, thus a rigorous pilot RCT is crucial...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28507939/variables-associated-with-adherence-to-stress-ulcer-prophylaxis-in-patients-admitted-to-the-general-hospital-wards-a-prospective-study
#7
Shadi Farsaei, Sajad Ghorbani, Payman Adibi
Purpose: The dramatic increase in stress ulcer prophylaxis (SUP) prescribing patterns over the past several years has raised concerns regarding to their appropriate utilization. This prospective study attempted to evaluate the trend of adherence to stress ulcer prophylaxis from admission until discharge in non- Intensive care unit (ICU) setting. Additionally, we attempted to find those variables associated with appropriate SUP administration. Methods: Data collection was performed prospectively to evaluate 195 randomly selected adult patients who received SUP or had indication for that in non-ICU wards of one of the largest referral center in Iran, during 6 months...
April 2017: Advanced Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/28506028/comparison-of-the-hospital-acquired-clostridium-difficile-infection-risk-of-using-proton-pump-inhibitors-versus-histamine-2-receptor-antagonists-for-prophylaxis-and-treatment-of-stress-ulcers-a-systematic-review-and-meta-analysis
#8
Mohamed Azab, Loomee Doo, Daniel H Doo, Yousif Elmofti, Muazer Ahmed, John Jay Cadavona, Xibei B Liu, Amaan Shafi, Moon Kyung Joo, Ji Won Yoo
Background/Aims: Although proton pump inhibitors (PPIs) have been widely used for the prevention and treatment of stress gastric ulcers in hospital settings, there are concerns that PPIs increase the risk of Clostridium difficile infection (CDI). However, little is known about the risk of CDI following PPI and histamine-2 receptor antagonist (H2RA) use. We evaluated the comparative hospital-acquired CDI occurrence risk associated with the concurrent use of PPIs versus H2RAs. Methods: A systematic search of PubMed, MEDLINE/ Ovid, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Google Scholar through August 19, 2016, identified 12 studies that reported the hospital-acquired CDI occurrence following H2RA and PPI use for the prevention and treatment of stress gastric ulcers...
May 17, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28461706/possibilities-for-modifying-risk-factors-for-the-development-of-hospital-acquired-pneumonia-in-intensive-care-patients-results-of-a-retrospective-observational-study
#9
Radovan Uvizl, Milan Kolar, Tomas Herkel, Michaela Vobrova, Katerina Langova
BACKGROUND: Hospital-acquired pneumonia (HAP) development is affected by a range of risk factors. METHODS: A retrospective, observational study processing data on all consecutive intensive care patients older than 18 years of age between 1 January 2011 and 31 December 2015. The aim was to determine the incidence of potential risk factors and their impact on the development of HAP. RESULTS: A total of 2229 patients. The overall mortality was 24...
April 26, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/28459708/withholding-pantoprazole-for-stress-ulcer-prophylaxis-in-critically-ill-patients-a-pilot-randomized-clinical-trial-and-meta-analysis
#10
Waleed Alhazzani, Gordon Guyatt, Mohammed Alshahrani, Adam M Deane, John C Marshall, Richard Hall, John Muscedere, Shane W English, François Lauzier, Lehana Thabane, Yaseen M Arabi, Tim Karachi, Bram Rochwerg, Simon Finfer, Nick Daneman, Fayez Alshamsi, Nicole Zytaruk, Diane Heel-Ansdell, Deborah Cook
INTRODUCTION: A decreased frequency of upper gastrointestinal bleeding and a possible association of proton pump inhibitor use with Clostridium difficile and ventilator-associated pneumonia have raised concerns recently. The Reevaluating the Inhibition of Stress Erosions Pilot Trial determined the feasibility of undertaking a larger trial investigating the efficacy and safety of withholding proton pump inhibitors in critically ill patients. METHODS: In 10 ICUs, we randomized adult ICU patients anticipated to be mechanically ventilated for greater than or equal to 48 hours to receive 40 mg of IV pantoprazole daily or placebo...
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28315586/sucralfate-versus-histamine-2-receptor-antagonists-for-stress-ulcer-prophylaxis-in-adult-critically-ill-patients-a-meta-analysis-and-trial-sequential-analysis-of-randomized-trials
#11
Mustafa Alquraini, Fayez Alshamsi, Morten Hylander Møller, Emilie Belley-Cote, Saleh Almenawer, Roman Jaeschke, Robert MacLaren, Waleed Alhazzani
PURPOSE: To determine the impact of using sucralfate versus H2RAs for SUP on patient important outcomes. MATERIALS AND METHODS: We searched CENTRAL, MEDLINE, EMBASE, ACPJC, clinical trials registries, and conference proceedings through June 2016 for randomized controlled trials (RCTs) comparing sucralfate to H2RAs for SUP in adult critically ill patients. RESULTS: 21 RCTs enrolling 3121 patients met inclusion criteria. There was no significant difference between sucralfate compared to H2RAs in the risk of clinically important GI bleeding (risk ratio [RR] 1...
March 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28288502/-s2k-guideline-helicobacter-pylori-and-gastroduodenal-ulcer-disease-2016-statement-on-stress-ulcer-prophylaxis-and-optimized-therapy
#12
Jörg C Hoffmann, Christian Prinz, Joachim Labenz, Stephan Miehlke, Peter Malfertheiner, Wolfgang Fischbach
No abstract text is available yet for this article.
March 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28279999/simplified-mortality-score-for-the-intensive-care-unit-sms-icu-protocol-for-the-development-and-validation-of-a-bedside-clinical-prediction-rule
#13
Anders Granholm, Anders Perner, Mette Krag, Peter Buhl Hjortrup, Nicolai Haase, Lars Broksø Holst, Søren Marker, Marie Oxenbøll Collet, Aksel Karl Georg Jensen, Morten Hylander Møller
INTRODUCTION: Mortality prediction scores are widely used in intensive care units (ICUs) and in research, but their predictive value deteriorates as scores age. Existing mortality prediction scores are imprecise and complex, which increases the risk of missing data and decreases the applicability bedside in daily clinical practice. We propose the development and validation of a new, simple and updated clinical prediction rule: the Simplified Mortality Score for use in the Intensive Care Unit (SMS-ICU)...
March 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28238056/what-s-new-with-stress-ulcer-prophylaxis-in-the-icu
#14
Søren Marker, Mette Krag, Morten Hylander Møller
No abstract text is available yet for this article.
August 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28185627/epidemiology-of-bleeding-in-critically-ill-children
#15
Lauren J White, Ryan Fredericks, Candace N Mannarino, Stephen Janofsky, Edward Vincent S Faustino
OBJECTIVE: To determine the epidemiology of bleeding in critically ill children. STUDY DESIGN: We conducted a cohort study of children <18 years old admitted to the pediatric intensive care unit for >24 hours and without clinically relevant bleed (CRB) on admission. CRB was defined as resulting in severe physiologic derangements, occurring at a critical site or requiring major therapeutic interventions. Using a novel bleeding assessment tool that we developed, characteristics of the CRB were abstracted from the medical records independently and in duplicate...
May 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28157394/how-prepared-are-medical-and-nursing-students-to-identify-common-hazards-in-the-intensive-care-unit
#16
Alison S Clay, Saumil M Chudgar, Kathleen M Turner, Jacqueline Vaughn, Nancy W Knudsen, Jeanne M Farnan, Vineet M Arora, Margory A Molloy
RATIONALE: Care in the hospital is hazardous. Harm in the hospital may prolong hospitalization, increase suffering, result in death, and increase costs of care. Although the interprofessional team is critical to eliminating hazards that may result in adverse events to patients, professional students' formal education may not prepare them adequately for this role. OBJECTIVES: To determine if medical and nursing students can identify hazards of hospitalization that could result in harm to patients and to detect differences between professions in the types of hazards identified...
April 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28110095/prophylaxis-for-stress-ulcers-with-proton-pump-inhibitors-is-not-associated-with-increased-risk-of-bloodstream-infections-in-the-intensive-care-unit
#17
Margot E Cohen, Joanne M Hathway, Hojjat Salmasian, Jianfang Liu, Melissa Terry, Julian A Abrams, Daniel E Freedberg
BACKGROUND & AIMS: Proton pump inhibitors (PPIs) have been associated with increased risk of infection, likely because of changes in intestinal epithelial permeability and the gastrointestinal microbiome. PPIs are frequently given to patients in the intensive care unit (ICU) to prevent stress ulcers. These patients are at risk for bloodstream infections (BSIs), so we investigated the relationship between PPI use and BSIs among patients in the ICU. METHODS: We performed a retrospective cohort study of adults (≥18 years) admitted to 1 of 14 ICUs within a hospital network of 3 large hospitals from 2008 through 2014...
July 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28093644/guidelines-for-proton-pump-inhibitor-prescriptions-in-paediatric-intensive-care-unit
#18
P Joret-Descout, S Dauger, M Bellaiche, O Bourdon, S Prot-Labarthe
Background Stress ulcer prophylaxis (SUP) is recommended in some situations to prevent upper gastrointestinal bleeding and is a component of standard care for patients admitted to the intensive care unit (ICU). Proton pump inhibitors (PPIs), already among the most widely prescribed drug classes, are being increasingly used. Objective To describe PPI prescribing patterns and their changes after the dissemination of guidelines. Setting Paediatric ICU (PICU), Robert-Debré Teaching Hospital, Paris, France, which admits about 800 patients annually, from full-term neonates to 18-year-olds...
February 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28006826/predictive-performance-of-the-simplified-acute-physiology-score-saps-ii-and-the-initial-sequential-organ-failure-assessment-sofa-score-in-acutely-ill-intensive-care-patients-post-hoc-analyses-of-the-sup-icu-inception-cohort-study
#19
Anders Granholm, Morten Hylander Møller, Mette Krag, Anders Perner, Peter Buhl Hjortrup
PURPOSE: Severity scores including the Simplified Acute Physiology Score (SAPS) II and the Sequential Organ Failure Assessment (SOFA) score are used in intensive care units (ICUs) to assess disease severity, predict mortality and in research. We aimed to assess the predictive performance of SAPS II and the initial SOFA score for in-hospital and 90-day mortality in a contemporary international cohort. METHODS: This was a post-hoc study of the Stress Ulcer Prophylaxis in the Intensive Care Unit (SUP-ICU) inception cohort study, which included acutely ill adults from ICUs across 11 countries (n = 1034)...
2016: PloS One
https://www.readbyqxmd.com/read/27920417/intensive-care-unit-stress-ulcer-prophylaxis-is-it-still-needed
#20
EDITORIAL
Majid A Almadi, Alan N Barkun
No abstract text is available yet for this article.
November 2016: Annals of Saudi Medicine
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