Enteral nutrition as stress ulcer prophylaxis in critically ill patients: A randomized controlled exploratory study

El‐Kersh, Karim; Jalil, Bilal; McClave, Stephen A.; Cavallazzi, Rodrigo; Guardiola, Juan; Guilkey, Karen; Persaud, Annuradha; Furmanek, Stephen; Guinn, Brian E.; Wiemken, Timothy; Alhariri, Bashar Chihada; Kellie, Scott P.; Saad, Mohamed

doi:10.1016/j.jcrc.2017.08.036

Cited by 51 publications

(82 citation statements)

References 42 publications

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“…In addition, SUP did not significantly affect mortality; a subsequent TSA analysis demonstrated futility for SUP for the reduction of mortality (Figure ; p=0.91, 95% CI 0.86–1.18). The five trials (656 participants) that examined CIB after the publication of EGDT demonstrated no significant benefit in CIB reduction with SUP. Medical and surgical ICU patients did not significantly benefit from SUP for CIB despite the presence of conventional risk factors (mechanical ventilation and coagulopathy).…”

Section: Resultsmentioning

confidence: 96%

“…Figure summarizes the results of the literature search: 34 trials in various languages were included. The main reasons for exclusion were wrong study design, incorrect comparator, and wrong study outcomes.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 3220 participants were included in this meta‐analysis. In 6 trials (502 participants), most patients were medical ICU admissions, 15 trials (1675 participants) enrolled a majority of surgery/trauma patients, 9 trials enrolled a majority of neurosurgical/traumatic brain injury patients (690 participants), and the remaining 4 trials were a mixture of ICU populations or did not describe the ICU population (353 participants). Five trials examined CIB after the publication of EGDT (656 participants), seven trials permitted or encouraged the use of enteral nutrition (960 participants), and four trials used gastric pH‐titrated therapy (421 participants).…”

Section: Resultsmentioning

confidence: 99%

“…The H 2 RAs were used in 31 trials (2741 participants), and PPIs were used in 6 trials (695 participants) . Three trials compared both H 2 RAs and PPIs with controls (424 participants) …”

Section: Resultsmentioning

confidence: 99%

“…The outcome of CIB was extractable from 25 trials (2275 participants). Of these trials, 22 involved the use of H 2 RAs (1691 participants) and 5 trials involved PPIs (584 participants); two trials had both PPIs and H 2 RAs .…”

Section: Resultsmentioning

confidence: 99%

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Re‐evaluating the Utility of Stress Ulcer Prophylaxis in the Critically Ill Patient: A Clinical Scenario‐Based Meta‐Analysis

MacLaren

2018

Pharmacotherapy

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…The H 2 RAs were used in 31 trials (2741 participants), and PPIs were used in 6 trials (695 participants) . Three trials compared both H 2 RAs and PPIs with controls (424 participants) …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Re‐evaluating the Utility of Stress Ulcer Prophylaxis in the Critically Ill Patient: A Clinical Scenario‐Based Meta‐Analysis

MacLaren

2018

Pharmacotherapy

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The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J‐SSCG 2020)

Egi

Ogura

Yatabe

et al. 2021

Acute Medicine & Surgery

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The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J‐SSCG 2020), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created as revised from J‐SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high‐quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J‐SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU‐acquired weakness [ICU‐AW], post‐intensive care syndrome [PICS], and body temperature management). The J‐SSCG 2020 covered a total of 22 areas with four additional new areas (patient‐ and family‐centered care, sepsis treatment system, neuro‐intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large‐scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members. As a result, 79 GRADE‐based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J‐SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines.

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Altering Routine Intensive Care Unit Practices to Support Commensalism

Hamilton

Behal

2020

Nut in Clin Prac

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The gastrointestinal (GI) tract consists of trillions of organisms that support multiple functions in the body, from immunity, digestion, and absorption to drug metabolism. These microbes form an overall collection of microorganisms that form the body's microbiome. In critical illness, many of these functions are aberrant, and the microbiome is altered, leading to untoward effects. Some of the most common medications received by patients include antibiotics and proton pump inhibitors, which affect particular changes in the microbiome. In addition, patients receiving prolonged enteral and parenteral nutrition experience changes in the microbiological composition and diversity of their GI tracts. Research is ongoing to characterize the crosstalk between the microbiome and immune function as targets for drug and nutrition therapy.

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Enteral nutrition as stress ulcer prophylaxis in critically ill patients: A randomized controlled exploratory study

Cited by 51 publications

References 42 publications

Re‐evaluating the Utility of Stress Ulcer Prophylaxis in the Critically Ill Patient: A Clinical Scenario‐Based Meta‐Analysis

Re‐evaluating the Utility of Stress Ulcer Prophylaxis in the Critically Ill Patient: A Clinical Scenario‐Based Meta‐Analysis

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J‐SSCG 2020)

Altering Routine Intensive Care Unit Practices to Support Commensalism

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