Nosocomial upper gastrointestinal tract bleeding

Gastric mucosal ulcers (stress ulcers), frequently implicated as an underlying cause.

Risk factors include mechanical ventilation, and coagulopathy which have been noted among patients in an ICU (Cook D et al).

Gastric acid suppression can provide effective prophylaxis against upper GI bleeding in ICU patients (Cook D et al).

Proton pump inhibitors suppress gastric acid production at the level of the hydrogen/potassium-adenosine triphosphate pathway and are widely prescribed for nosocomial upper gastrointestinal bleeding prophylaxis.

Acid suppressive therapy given to patients outside of the intensive care unit and who were not critically ill decreased nosocomial G.I. bleeding, to a minor extent, such that the number of patients needed to be treated to prevent one case of such bleeding was 770 patients(Herzig sl et al).

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