Prophylaxis Archives - Critical Care Science (CCS)
Abstract
Rev Bras Ter Intensiva. 2019;31(1):5-14
DOI 10.5935/0103-507X.20190002
Critically ill patients are at risk of developing stress ulcers in the upper digestive tract. Agents that suppress gastric acid are commonly prescribed to reduce the incidence of clinically important stress ulcer-related gastrointestinal bleeding. However, the indiscriminate use of stress ulcer prophylaxis in all patients admitted to the intensive care unit is not warranted and can have potential adverse clinical effects and cost implications. The present guidelines from the Sociedade Portuguesa de Cuidados Intensivos summarizes the current evidence and gives six clinical statements and an algorithm aiming to provide a standardized prescribing policy for the use of stress ulcer prophylaxis in the intensive care unit.
Abstract
Rev Bras Ter Intensiva. 2019;31(1):5-14
DOI 10.5935/0103-507X.20190002
Critically ill patients are at risk of developing stress ulcers in the upper digestive tract. Agents that suppress gastric acid are commonly prescribed to reduce the incidence of clinically important stress ulcer-related gastrointestinal bleeding. However, the indiscriminate use of stress ulcer prophylaxis in all patients admitted to the intensive care unit is not warranted and can have potential adverse clinical effects and cost implications. The present guidelines from the Sociedade Portuguesa de Cuidados Intensivos summarizes the current evidence and gives six clinical statements and an algorithm aiming to provide a standardized prescribing policy for the use of stress ulcer prophylaxis in the intensive care unit.
Abstract
Rev Bras Ter Intensiva. 2006;18(3):229-233
DOI 10.1590/S0103-507X2006000300003
BACKGROUND AND OBJECTIVES: Gastrointestinal bleeding due to stress ulcer (GB) complicates critical disease, and must be received prophylaxis based on defined criteria. To evaluate the GB prophylaxis in Intensive Care Units (ICU), and to compare with the guidelines. METHODS: We carried out a cross-sectional multicenter study in 21 medical-surgical ICU in Brazil to investigate this issue. For data analysis, these were distributed in 3 sub-groups (high, moderate and low risk for GB). RESULTS: 235 patients were evaluated, with mean age of 57.7 ± 19.5 years and days on ICU 13 ± 19.7. The more common admission ICU diagnoses were sepsis (26%) and postoperative (16.2%) patients. Seventy-three (73%) of the patients were GB high risk, 21.5% moderate and 5.5% low risk. Of the 187 high risk patients, 139 were receiving GB prophylaxis (60% with histamine blockers (HB2) and 39% with proton pump inhibitors (PPI). Of these patients, 25.7% did not receive GU prophylaxis, although indicated it. Of the 55 moderate risk patients, 70.9% wer e receiving GU prophylaxis (22 with HB2 and 17 with PPI). Of the 14 low risk patients, 71% were using GU prophylaxis (6 with HB2 and 4 with PPI). CONCLUSIONS: Almost 80% of the patients made use of GB prophylactic drugs, with no agreement GU risk stratification. This study demonstrated the no adequate GU prophylaxis in the Brazilian ICU.
Abstract
Rev Bras Ter Intensiva. 2006;18(3):229-233
DOI 10.1590/S0103-507X2006000300003
BACKGROUND AND OBJECTIVES: Gastrointestinal bleeding due to stress ulcer (GB) complicates critical disease, and must be received prophylaxis based on defined criteria. To evaluate the GB prophylaxis in Intensive Care Units (ICU), and to compare with the guidelines. METHODS: We carried out a cross-sectional multicenter study in 21 medical-surgical ICU in Brazil to investigate this issue. For data analysis, these were distributed in 3 sub-groups (high, moderate and low risk for GB). RESULTS: 235 patients were evaluated, with mean age of 57.7 ± 19.5 years and days on ICU 13 ± 19.7. The more common admission ICU diagnoses were sepsis (26%) and postoperative (16.2%) patients. Seventy-three (73%) of the patients were GB high risk, 21.5% moderate and 5.5% low risk. Of the 187 high risk patients, 139 were receiving GB prophylaxis (60% with histamine blockers (HB2) and 39% with proton pump inhibitors (PPI). Of these patients, 25.7% did not receive GU prophylaxis, although indicated it. Of the 55 moderate risk patients, 70.9% wer e receiving GU prophylaxis (22 with HB2 and 17 with PPI). Of the 14 low risk patients, 71% were using GU prophylaxis (6 with HB2 and 4 with PPI). CONCLUSIONS: Almost 80% of the patients made use of GB prophylactic drugs, with no agreement GU risk stratification. This study demonstrated the no adequate GU prophylaxis in the Brazilian ICU.