Efficacy and safety of gastrointestinal bleeding prophylaxis in critically ill patients

Researchers examined evidence from 72 randomized controlled trials in their systematic review and network meta-analysis of strategies for preventing gastrointestinal bleeding in the critically ill population.

Researchers examined evidence from 72 randomized controlled trials in their systematic review and network meta-analysis of strategies for preventing gastrointestinal bleeding in the critically ill population. The studies included 12,660 patients and investigated prophylaxis using proton pump inhibitors (PPIs), histamine-2 receptor antagonists (H2RAs), or sucralfate. The interventions were compared against one another, placebo, or no prophylaxis. Based on the data, the investigators determined that PPIs and H2RAs appear to significantly reduce gastrointestinal bleeding in critically ill patients with higher risk—although they also increased the risk for pneumonia—compared with no prophylaxis. Meanwhile, the data offered no evidence that the interventions had any effect on mortality or other in-hospital morbidity endpoints.