Enteral nutrition better than proton pump inhibitors?

Bilal A. Jalil, Karim El-Kersh

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of review: Stress ulcer prophylaxis in critically-ill patients has been a subject of extensive research, with multiple clinical trials attempting to study the best method of stress ulcer prophylaxis with the least adverse effects. Until recently, pharmacologic prophylaxis has prevailed as the primary choice for the prevention of stress ulcers but recent clinical studies have attempted to evaluate the role of enteral nutrition in stress ulcer prophylaxis. Recent findings: The incidence of stress ulcers that result in clinically important gastrointestinal bleeding (CIGIB) has drastically decreased over the last two decades. Furthermore, in the current era CIGB in the ICU does not seem to be associated with an increased mortality. Multiple recent clinical studies aimed to evaluate the role of proton pump inhibitors (PPIs) in patients who tolerate enteral nutrition in the ICU. Summary: The results of multiple recent clinical studies call for re-evaluation of the routine use of PPIs in critically ill patients who tolerates enteral nutrition in the ICU. Despite the promising preliminary results, definitive recommendations need larger clinical trials that are powered to evaluate any added benefits of using PPI in critically ill patients who tolerate enteral nutrition given the low incidence of CIGB in the current era.

Original languageEnglish (US)
Pages (from-to)334-339
Number of pages6
JournalCurrent Opinion in Critical Care
Volume25
Issue number4
DOIs
StatePublished - Aug 1 2019
Externally publishedYes

Keywords

  • critical care nutrition
  • enteral nutrition
  • proton pump inhibitors
  • stress ulcer prophylaxis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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