| REVIEW ARTICLE |
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| Year : 2017 | Volume
: 1
| Issue : 6 | Page : 31-33 |
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Stress ulcer prophylaxis: Back to square one
Mohammed Alshahrani1, Waleed Alhazzani2
1 Department of Emergency and Critical Care, College of Medicine, Imam Abdulrahman Ben Faisal University, Dammam, Saudi Arabia
2 Department of Medicine, Division of Critical Care and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
Correspondence Address:
Waleed Alhazzani
Department of Medicine, Division of Critical Care, McMaster University, St Joseph's Healthcare Hamilton, 50 Charlton Avenue, Postal Code L8N 4A6, Hamilton, Ontario
Canada
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2543-1854.219136
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Pharmacologic prophylaxis against stress ulcer-related gastrointestinal (GI) bleeding with acid suppression has been the standard of care for decades. Worldwide, proton pump inhibitors (PPIs) are more commonly used than histamine-2-receptor antagonists. However, recent observational studies suggest that PPIs increase the risk of ventilator-associated pneumonia (VAP) and Clostridium difficile infection (CDI). Further, the incidence of GI bleeding appears to be lower than in the past, perhaps related to immediate resuscitation and enteral nutrition. a large randomized trial is needed to test the efficacy and safety of withholding PPIs in the ICU. |
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