Stress ulcer prophylaxis in the intensive care unit: An international survey of 97 units in 11 countries

Mette Krag, Anders Perner, Jorn Wetterslev, Matt Wise, Mark Borthwick, S Bendel, C. McArthur, Deborah Cook, Niklas Nielsen, Paolo Pelosi, Frederik Keus, Anne Guttormsen, Alma Moller, Morten Moller, Alan Timmins, Alastair Raynes, Alistair Gibson, Anders Oldner, Andrew Walden, Andrew ParsonsAnja Richter, Anna Tilsley, Anne Lindhardt, Birgitta Lindqvist, Birgitte Majholm, Catherine Loughlin, Cheh Tai, Christina Lundin, Craig French, David Lodahl, David Sapsford, Dhanesh Solanki, Edward Curtis, Emma Graham-Clarke, Emma Smith, Fayez Alshamsi, Gavin Perkins, Gillian Kincaid, Greg Barton, Greg Fletcher, Hans Friberg, Hans Betsch, Helle Bundgaard, Henrieta Jidbratt, Henrik Christensen, Jack Parry-Jones, Jane Nielsen, Jennifer Thomson, Jens Nilsson, Jessica West, Joanne Oxlade, Joanne Price, John Adams, John Muscedere, John Santamaria, Jon Laake, Julius Cranshaw, Katie Davies, Kirsty Gladas, Kristian Madsen, Line Madsen, Lone Poulsen, Lynette Newby, Madhankumar Vijayakumar, Maj Kamper, Marie Sellert-Rydberg, Markus Weis, Martin Krog, Mary Madden, Matias Lindholm, Matti Reinikainen, Mike Barker, Minna Backlund, Monika Thomas, Morten Freundlich, Murray Blackstock, Natalie Edwards, Olena Breum, Oliver Ralley, Paul Young, Pawel Berezowicz, Peter van der Voort, Peter Young, Rachael Parke, Raili Laru-Sompa, Richard Hall, Roar Medici, Robert Svensson, Sari Karlsson, Seppo Hovilehto, Shailesh Bihari, Simon Bjorn-Praest, Siv Lievdal, Staffan Palsson, Stig Dyrskog, Susan Ramsay, Susanne Iversen, Suveer Singh, Suzanne Odeberg-Wernerman, Victoria Glaister, Waleed Alhazzani

    Research output: Contribution to journalArticle

    55 Citations (Scopus)

    Abstract

    Background Stress ulcer prophylaxis (SUP) may decrease the incidence of gastrointestinal bleeding in patients in the intensive care unit (ICU), but the risk of infection may be increased. In this study, we aimed to describe SUP practices in adult ICUs. We hypothesised that patient selection for SUP varies both within and between countries. Methods Adult ICUs were invited to participate in the survey. We registered country, type of hospital, type and size of ICU, preferred SUP agent, presence of local guideline, reported indications for SUP, criteria for discontinuing SUP, and concerns about adverse effects. Fisher's exact test was used to assess differences between groups. Results Ninety-seven adult ICUs in 11 countries participated (eight European). All but one ICU used SUP, and 64% (62/97) reported having a guideline for the use of SUP. Proton pump inhibitors were the most common SUP agent, used in 66% of ICUs (64/97), and H2-receptor antagonists were used 31% (30/97) of the units. Twenty-three different indications for SUP were reported, the most frequent being mechanical ventilation. All patients were prescribed SUP in 26% (25/97) of the ICUs. Adequate enteral feeding was the most frequent reason for discontinuing SUP, but 19% (18/97) continued SUP upon ICU discharge. The majority expressed concern about nosocomial pneumonia and Clostridium difficile infection with the use of SUP. Conclusions In this international survey, most participating ICUs reported using SUP, primarily proton pump inhibitors, but many did not have a guideline; indications varied considerably and concern existed about infectious complications.

    Original languageEnglish
    Pages (from-to)576-585
    Number of pages10
    JournalACTA ANAESTHESIOLOGICA SCANDINAVICA
    Volume59
    Issue number5
    DOIs
    Publication statusPublished - 2015

    Fingerprint Dive into the research topics of 'Stress ulcer prophylaxis in the intensive care unit: An international survey of 97 units in 11 countries'. Together they form a unique fingerprint.

  • Cite this

    Krag, M., Perner, A., Wetterslev, J., Wise, M., Borthwick, M., Bendel, S., McArthur, C., Cook, D., Nielsen, N., Pelosi, P., Keus, F., Guttormsen, A., Moller, A., Moller, M., Timmins, A., Raynes, A., Gibson, A., Oldner, A., Walden, A., ... Alhazzani, W. (2015). Stress ulcer prophylaxis in the intensive care unit: An international survey of 97 units in 11 countries. ACTA ANAESTHESIOLOGICA SCANDINAVICA, 59(5), 576-585. https://doi.org/10.1111/aas.12508