SCCM Resource Library-Use and Misuse of Gastric Acid Prophylaxis in Critical Care Discussion

Use and Misuse of Gastric Acid Prophylaxis in Critical Care Discussion

Video Transcription

Video Summary

The presentation discusses stress ulcer prophylaxis, focusing on the evolution of clinical practices and evidence-based practices concerning acid suppressive treatments. Initially, antacids and H2 blockers were used, but they posed a risk of nosocomial pneumonia. Research eventually favored H2 blockers over antacids, and later proton pump inhibitors (PPIs) emerged as a more potent alternative, though they too pose risks like C. diff and renal issues, especially with long-term use. Current guidelines recommend targeting high-risk patients for stress ulcer prophylaxis, primarily those with coagulopathy or on mechanical ventilation. However, misuse and overuse of these prophylactic treatments are common, and recent studies suggest the true incidence of clinically significant GI bleeding may be lower than previously thought. Ongoing research, including recent trials and upcoming guidelines, aims to clarify the necessity and scope of stress ulcer prophylaxis, advocating for careful risk assessment before administering such treatments.

Asset Caption

45-Minute Session | Use and Misuse of Gastric Acid Prophylaxis in Critical Care

Meta Tag

Content Type Presentation

Membership Level Professional

Membership Level Select

Year 2024

Keywords

stress ulcer prophylaxis

acid suppressive treatments

H2 blockers

proton pump inhibitors

clinical guidelines

risk assessment

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