Efficacy and safety of gastrointestinal bleeding prophylaxis in critically ill patients: systematic review and network meta-analysis -

Efficacy and safety of gastrointestinal bleeding prophylaxis in critically ill patients: systematic review and network meta-analysis
Information type: Systematic reviews
Source: British Medical Journal
Specialities: Gastrointestinal disorders
Summary
Review of 72RCTs shows in those at highest risk (>8%) or high risk (4-8%) of bleeding, both PPIs and H2RAs reduce GI bleeding v placebo or no prophylaxis (OR PPIs 0.61, 3.3% fewer for highest risk and 2.3% fewer for high risk patients; OR H2RAs 0.46, 4.6% and 3.1% respectively).
UKMi comment

The authors highlight that the review is limited by the fact that definitions of clinically important gastrointestinal bleeding and overt bleeding differed; most, however, adhered to standard criteria. Additionally, most trials did not report the duration of follow-up.

The BMJ has also published a separate practice guideline to guide recommendations for GI prophylaxis in this setting.
Related links: Link to practice guideline