Drug Therapy

Stress ulcer prophylaxis: The case for a selective approach

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Although stress-related mucosal damage is common (and potentially serious) in critically ill patients, the risk of clinically significant gastrointestinal bleeding appears to be confined to patients with certain factors: mechanical ventilation, coagulopathy, multiple trauma, increased intracranial pressure, and multiorgan dysfunction. Because prophylactic therapy also poses risks, we advocate reserving it for patients in these high-risk groups.



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