Monday, March 24, 2014

A Note of Proton Pump Inhibitors (PPIs) use in ICU


"There is increasing concern that IV PPI is being prescribed inappropriately in the hospital and community setting. The use of IV PPI as prophylaxis against stress-related mucosal injury needs to be judicious. Routine prophylaxis is not cost-effective, and may subject patients to unnecessary side effects. It should be reserved for patients who are at higher risk of developing stress related ulcers. Acid-suppressive therapy is often inappropriately continued post ICU discharge, and even beyond hospital discharge in the community. Physicians should review and discontinue the use of IV PPI when the risk factors responsible for stress related mucosal injury are no longer present, and ensure that there is adequate communication with the treating team upon a patient's transfer out of ICU, and also with the community medical care provider upon hospital discharge."



Reference: 

Sandy H. Pang, David Y. Graham - A clinical guide to using intravenous proton-pump inhibitors in reflux and peptic ulcers- Therap Adv Gastroenterol. Jan 2010; 3(1): 11–22.

No comments:

Post a Comment