Stress ulcer prophylaxis practice in UK critical care units: A comparison of cross-sectional surveys between 2020 and 2024.

IF 1.4 Q3 CRITICAL CARE MEDICINE

Journal of the Intensive Care Society Pub Date : 2025-05-26 DOI:10.1177/17511437251338614

Mark Borthwick, Greg Barton, Emma Boxall, John P Dade, Odran Farrell, Ruth Forrest, Emma Graham-Clarke, David Kean, Helen Leigh, Reena Mehta, Gillian Mulherron, Ruth Roadley-Battin, David Sapsford, Alan Timmins, John Warburton, Richard S Bourne

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引用次数: 0

Abstract

Background: Critically ill patients are at risk of bleeding from stress ulcers. Comprehensive information regarding United Kingdom stress ulcer prophylaxis (SUP) practices are not available and may change over time. We aimed to describe SUP practices in 2020 and reevaluate the position in 2024.

Methods: Critical care pharmacists provided observed SUP practice data for UK adult critical care units via an electronic repository in 2020 and 2024. One response was accepted from each critical care unit at each time point. Data collected included trigger criteria for commencing SUP, primary medication class used, primary SUP cessation criteria, and level of nutritional intake (if part of cessation criteria).

Results: There were high response rates of 70.3% (2020) and 66.7% (2024) of registered UK adult critical care units. Few differences in primary SUP trigger criteria between 2020 and 2024 were seen, with small differences in the categories of 'SUP not used' (p = 0.002) and 'Shock' (p = 0.027) driving statistical significance (χ²(7, 454) = 16.76, p = 0.019). There was a significant change in the primary medication class used for SUP (H2 receptor antagonist 49.4% 2020, vs 0.4% 2024, proton pump inhibitor 44.7% 2020 vs 97.8% 2024; χ²(2, 458) = 159.62, p < 0.001). Primary SUP cessation criteria was 'Patient fed' (66.8% 2020, 64.6% 2024), with most describing this threshold as met when the patient receives full enteral feed (72.0% 2020, 78.8% 2024).

Conclusion: The UK has moved towards proton pump inhibitors as the primary SUP medication class. SUP is most frequently discontinued on establishment of enteral nutrition.

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英国重症监护病房的应激性溃疡预防实践：2020年至2024年横断面调查的比较

背景：危重病人有应激性溃疡出血的危险。关于英国应激性溃疡预防（SUP）实践的综合信息是不可用的，可能会随着时间的推移而改变。我们的目标是在2020年描述SUP实践，并在2024年重新评估位置。方法：重症监护药剂师通过电子存储库提供2020年和2024年英国成人重症监护病房的观察SUP实践数据。在每个时间点接受每个重症监护病房的一份回复。收集的数据包括开始SUP的触发标准、使用的主要药物类别、主要SUP停止标准和营养摄入水平（如果是停止标准的一部分）。结果：英国注册成人重症监护病房的有效率分别为70.3%（2020年）和66.7%（2024年）。2020年和2024年之间的主要SUP触发标准差异不大，“未使用SUP”（p = 0.002）和“休克”（p = 0.027）类别差异不大，具有统计学意义（χ2(7, 454) = 16.76, p = 0.019）。SUP (H2受体拮抗剂，2020年为49.4%，2024年为0.4%；质子泵抑制剂，2020年为44.7%，2024年为97.8%；χ2(2,458) = 159.62， p结论：英国已将质子泵抑制剂作为主要的SUP药物类别。SUP最常在肠内营养建立后停止使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the Intensive Care Society Nursing-Critical Care Nursing

CiteScore

4.40

自引率

0.00%

发文量

期刊介绍： The Journal of the Intensive Care Society (JICS) is an international, peer-reviewed journal that strives to disseminate clinically and scientifically relevant peer-reviewed research, evaluation, experience and opinion to all staff working in the field of intensive care medicine. Our aim is to inform clinicians on the provision of best practice and provide direction for innovative scientific research in what is one of the broadest and most multi-disciplinary healthcare specialties. While original articles and systematic reviews lie at the heart of the Journal, we also value and recognise the need for opinion articles, case reports and correspondence to guide clinically and scientifically important areas in which conclusive evidence is lacking. The style of the Journal is based on its founding mission statement to ‘instruct, inform and entertain by encompassing the best aspects of both tabloid and broadsheet''.