Intro: Stress ulcers can occur in the gastrointestinal (GI) tract during critical illness. These stress ulcers can bleed, causing worsening illness in a person who is already seriously ill.
In this study, the authors concluded that proton pump inhibitors (PPIs) are better than histamine-2 receptor antagonist (H2RAs) in high risk critically ill patients.
The study lead to guidelines on the prevention of gastrointestinal bleeding which occurs in 4% of critically ill patients, particularly those on mechanical ventilatory support without enteral feeding and those with chronic liver disease.
Even though there is a risk of pneumonia with chronic acid suppression, the benefits of using PPIs in critically ill patients to prevent GI bleed outweighs the risks of pneumonia.
Review by Dr. Ngozi Onuoha.