Pharmacy to Dose: The Critical Care Podcast
Stress Ulcer Prophylaxis
Oct 30, 2024
Rob MacLaren, BSc, PharmD, MPH, MCCM, FCCP, is a critical care pharmacist and professor at the University of Colorado Skaggs School of Pharmacy, renowned for his expertise in stress ulcer prophylaxis guidelines. He discusses the evolving landscape of stress ulcer prevention, including risk factors for critically ill patients and the distinction between H2RA and PPI treatments. Key studies, such as the REVISE trial, are examined for their impact on guidelines. MacLaren also emphasizes the importance of a targeted, evidence-based approach, raising critical questions about blanket medication use in ICUs.
50:34
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Quick takeaways
- The updated guidelines for stress ulcer prophylaxis emphasize individualized risk assessment and the importance of cautiously selecting between H2 blockers and PPIs based on patient conditions.
- Recent research highlights enteral nutrition not only as a feeding method but also as a protective factor against gastrointestinal bleeding, challenging traditional views on risk assessment.
Deep dives
Evolution of Stress Ulcer Prophylaxis Guidelines
The recent guidelines for stress ulcer prophylaxis are a significant update from the previous 1999 recommendations. The focus now shifts toward identifying specific risk factors that extend beyond traditional indicators, such as coagulopathy and mechanical ventilation. The new research emphasizes the role of enteral nutrition as not just a method of feeding but as a protective factor against gastrointestinal bleeding. With an emphasis on evidence-based recommendations, these guidelines arose from over a decade of effort by a multidisciplinary panel, culminating in a concerted push to align current practices with recent clinical research.
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