Efficacy and safety of proton pump inhibitors for stress ulcer prophylaxis in critically ill patients: a systematic review and meta-analysis of randomized trials
Autor: | Waleed Alhazzani, Awad Al-Omari, Gordon H. Guyatt, Zuhoor Alqahtani, Kim M. Lewis, Fayez Alshamsi, Saleh A. Almenawer, Dan Perri, Emilie P. Belley-Côté, Deborah J. Cook, Lehana Thabane |
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Jazyk: | angličtina |
Předmět: |
Peptic Ulcer
medicine.medical_specialty Low Confidence Cochrane Library Critical Care and Intensive Care Medicine Risk Assessment law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Humans Medicine Stomach Ulcer 030212 general & internal medicine Randomized Controlled Trials as Topic business.industry Research Stress ulcer Proton Pump Inhibitors 030208 emergency & critical care medicine Clostridium difficile medicine.disease Clinical trial Pneumonia Histamine H2 Antagonists Duodenal Ulcer Meta-analysis Gastrointestinal Hemorrhage business |
Zdroj: | Critical Care |
ISSN: | 1364-8535 |
DOI: | 10.1186/s13054-016-1305-6 |
Popis: | The relative efficacy and safety of proton pump inhibitors (PPIs) compared to histamine-2-receptor antagonists (H2RAs) should guide their use in reducing bleeding risk in the critically ill. We searched the Cochrane library, MEDLINE, EMBASE, ACPJC, clinical trials registries, and conference proceedings through November 2015 without language or publication date restrictions. Only randomized controlled trials (RCTs) of PPIs vs H2RAs for stress ulcer prophylaxis in critically ill adults for clinically important bleeding, overt gastrointestinal (GI) bleeding, nosocomial pneumonia, mortality, ICU length of stay and Clostridium difficile infection were included. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess our confidence in the evidence for each outcome. In 19 trials enrolling 2117 patients, PPIs were more effective than H2RAs in reducing the risk of clinically important GI bleeding (RR 0.39; 95 % CI 0.21, 0.71; P = 0.002; I 2 = 0 %, moderate confidence) and overt GI bleeding (RR 0.48; 95 % CI 0.34, 0.66; P |
Databáze: | OpenAIRE |
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