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Practice Guideline
. 2019;31(1):5-14.
doi: 10.5935/0103-507X.20190002. Epub 2019 Feb 28.

Sociedade Portuguesa de Cuidados Intensivos guidelines for stress ulcer prophylaxis in the intensive care unit

[Article in Portuguese, English]
João João Mendes  1 , Mário Jorge Silva  2 , Luís Silva Miguel  3 , Maria Albertina Gonçalves  1 , Maria João Oliveira  4 , Catarina da Luz Oliveira  5 , João Gouveia  1
Affiliations
Practice Guideline

Sociedade Portuguesa de Cuidados Intensivos guidelines for stress ulcer prophylaxis in the intensive care unit

[Article in Portuguese, English]
João João Mendes et al. Rev Bras Ter Intensiva. 2019.

Abstract
in English, Portuguese

Critically ill patients are at risk of developing stress ulcers in the upper digestive tract. Agents that suppress gastric acid are commonly prescribed to reduce the incidence of clinically important stress ulcer-related gastrointestinal bleeding. However, the indiscriminate use of stress ulcer prophylaxis in all patients admitted to the intensive care unit is not warranted and can have potential adverse clinical effects and cost implications. The present guidelines from the Sociedade Portuguesa de Cuidados Intensivos summarizes the current evidence and gives six clinical statements and an algorithm aiming to provide a standardized prescribing policy for the use of stress ulcer prophylaxis in the intensive care unit.

O paciente crítico corre risco de desenvolver úlceras de estresse do trato gastrintestinal. Antiácidos e antiulcerosos de diferentes classes são frequentemente prescritos para reduzir a incidência de hemorragia gastrintestinal clinicamente significativa associada à úlcera de estresse. No entanto, o uso indiscriminado deste tipo de profilaxia em todos os pacientes admitidos a unidades de terapia intensiva não só não se justifica, como tem potenciais efeitos adversos e implicações de custo. As presentes diretrizes da Sociedade Portuguesa de Cuidados Intensivos resume a evidência atual e fornece seis afirmações clínicas e um algoritmo com o objetivo de fornecer uma política padronizada para prescrição de profilaxia da úlcera estresse em unidades de terapia intensiva.

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Conflict of interest statement

Conflicts of interest: None.

Figures

Figure 1
Figure 1
Algorithm for prophylaxis of stress ulcer bleeding in the intensive care unit. * If Clostridium difficile infection and indications for stress ulcer prophylaxis favor histamine-2-receptor antagonists. INR - International Normalized Ratio; aPPT - activated partial thromboplastin time; SOFA - Sequential Organ Failure Assessment.
See this image and copyright information in PMC

References

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