Prophylaxis for stress-related gastrointestinal hemorrhage

Impact of Trauma Stress Ulcer Prophylaxis Guidelines on Drug Cost and Frequency of Major Gastrointestinal Bleeding

“…A cost-effectiveness analysis showed the cost of prophylaxis to be prohibitive in all but the highest-risk patient populations. 41 Assuming that prophylaxis reduced the risk of hemorrhage by 50%, the cost/bleeding event averted in low-risk patients was $103,725.…”

Pharmacoeconomic Modeling of Lorazepam, Midazolam, and Propofol for Continuous Sedation in Critically Ill Patients

“…Costs of adverse events included those associated with personnel time, additional drugs, additional laboratory or diagnostic analyses, and downstream events ( Table 1). [78][79][80][81][82][83][84][85][86] Level and lack of sedation control were included to assess oversedation or undersedation, which reflected neurologic evaluation or treatment of acute anxiety and/or agitation, respectively. The primary effects of time to awakening after the discontinuation of sedation were delayed extubation and neurologic evaluation with computed tomography due to prolonged awakening or treatment of acute anxiety and/or agitation for rapid awakening.…”

“…Parameter estimates for adverse events and drug use differed between sedatives and time frames ( Table 2). [80][81][82][83] In general, propofol was associated with rapid awakening and extubation after it was discontinued, but postsedation agitation was more common with propofol than with the other sedatives. In contrast, awakening and extubation were delayed with lorazepam and midazolam, increasing the number of postsedation neurologic assessments.…”

“…The rate of ventilator-associated pneumonia was 6.94 x 10 -6 /minute of additional tracheal ventilation due to prolonged extubation resulting from slow awakening. [81][82][83] We assumed that 6.9% of patients with propofol-induced hypertriglyceridemia underwent abdominal computed tomography because of suspected pancreatitis and that 98.1% of the scans showed evidence of pancreatitis requiring additional treatment. 80 Caloric intake was not adjusted in any patient requiring short-term sedation with propofol, but intravenous lipid administration was discontinued in an estimated 10% and 25% of patients requiring intermediate-and long-term sedation, respectively, because of propofol.…”

“…Various definitions of optimal sedation were Rate of ventilator-associated pneumonia was 6.94 x 10 -6 /minute of tracheal ventilation. [81][82][83] used. Overall, the time spent at goal sedation were similar for all three sedatives for all durations, with propofol providing the most consistent and adequate sedation ( Table 5).…”