Gepost in: GI en voeding
What’s new with stress ulcer prophylaxis in the ICU?
What is known?
Critically ill patients are at risk of stress-related mucosal erosions. Tese are typically superfcial and asymptomatic but may progress to ulceration and overt and clinically important gastrointestinal (GI) bleeding, a serious condition associated with increased morbidity and mortality. Te reported incidence of GI bleeding varies between 2 and 5%, probably because of heterogeneous populations, varying defnitions of GI bleeding, and difculties in diagnosing stress ulcers. Importantly, stress ulcerations have been identifed as the sole source of GI bleeding by endoscopy in fewer than 50% of patients with GI bleeding. A number of risk factors for stress ulcer-related bleedings have been suggested, including mechanical ventilation, coagulopathy, acute kidney injury, hepatic failure, and disease severity. A protective efect of enteral nutrition has been proposed, however this has not been confrmed in subsequent studies.
Søren Marker, Mette Krag and Morten Hylander Møller
Intensive Care Med (2017) 43:1132–1134 DOI 10.1007/s00134-017-4733-0