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
{"title":"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","authors":"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","doi":"10.1177/17511437251338614","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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' (<i>p</i> = 0.002) and 'Shock' (<i>p</i> = 0.027) driving statistical significance (χ<sup>2</sup>(7, 454) = 16.76, <i>p</i> = 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; χ<sup>2</sup>(2, 458) = 159.62, <i>p</i> < 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).</p><p><strong>Conclusion: </strong>The UK has moved towards proton pump inhibitors as the primary SUP medication class. SUP is most frequently discontinued on establishment of enteral nutrition.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251338614"},"PeriodicalIF":1.4000,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106379/pdf/","citationCount":"0","resultStr":"{\"title\":\"Stress ulcer prophylaxis practice in UK critical care units: A comparison of cross-sectional surveys between 2020 and 2024.\",\"authors\":\"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\",\"doi\":\"10.1177/17511437251338614\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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' (<i>p</i> = 0.002) and 'Shock' (<i>p</i> = 0.027) driving statistical significance (χ<sup>2</sup>(7, 454) = 16.76, <i>p</i> = 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; χ<sup>2</sup>(2, 458) = 159.62, <i>p</i> < 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).</p><p><strong>Conclusion: </strong>The UK has moved towards proton pump inhibitors as the primary SUP medication class. SUP is most frequently discontinued on establishment of enteral nutrition.</p>\",\"PeriodicalId\":39161,\"journal\":{\"name\":\"Journal of the Intensive Care Society\",\"volume\":\" \",\"pages\":\"17511437251338614\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-05-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106379/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the Intensive Care Society\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/17511437251338614\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Intensive Care Society","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/17511437251338614","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
Stress ulcer prophylaxis practice in UK critical care units: A comparison of cross-sectional surveys between 2020 and 2024.
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.
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''.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
