| Popis: |
OBJECTIVES: To determine the main indications for gastric ulcer prophylaxis in hospitalized pediatric patients and, through the analysis of scientific evidence, to point out the main complications of the indiscriminate use of this prophylaxis and to mention alternatives to the use of drugs in the prevention of stress ulcers. METHODS: We selected articles written in English and Portuguese, published between 2009 and 2019, which show the indications of stress ulcer prophylaxis in critically ill pediatric patients, as well as studies demonstrating the complications of gastric acid suppression therapy. The search was performed in the PubMed, LILACS and SciELO databases. RESULTS: In this integrative review, sixteen studies that met the previously established inclusion criteria were analyzed. Of the articles included in this study, four are prospective observational studies, eight are systematic reviews, seven with meta-analysis, two retrospective cohort studies, one case-control study, one expert-opinion guideline, and one case report. CONCLUSION: The indiscriminate use of stress ulcer prophylaxis is not recommended and should only be used when there is an accurate indication. However, even where therapy is recommended, the risk-benefit assessment should be assessed and caution should be exercised with acid-suppressing drugs, as this prophylaxis increases the risk of Clostridium difficile infection and pneumonia. It is also suggested the introduction of early enteral nutrition as an alternative to the use of gastric ulcer drug prophylaxis, as the evidence points to its efficacy in reducing adverse effects and maintaining gastric homeostasis. |
