Review
Critical Care Medicine
Hasan M. Al-Dorzi, Yaseen M. Arabi
Summary: The incidence of stress-induced clinically important gastrointestinal bleeding in critically ill patients seems to be decreasing. Early enteral nutrition and proton pump inhibitors may be effective in preventing gastrointestinal bleeding, but questions remain regarding which patients are likely to benefit the most.
CURRENT OPINION IN CRITICAL CARE
(2021)
Article
Gastroenterology & Hepatology
Chen Chen, Hui Liu, Ruqiao Duan, Fangfang Wang, Liping Duan
Summary: In the CCU setting, the use of PPIs and H2RAs for GIB prophylaxis was not associated with a lower risk of CIGIB compared to the control group. Additionally, PPI therapy may increase the risk of in-hospital mortality in patients over 75 years old. PPIs could also increase the risk of HAP in patients with heart failure.
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
(2021)
Article
Medicine, General & Internal
Todd C. Lee, Marnie Goodwin Wilson, Alexander Lawandi, Emily G. McDonald
Summary: A meta-analysis showed that in critically ill patients, the use of proton pump inhibitors for stress ulcer prophylaxis may increase mortality compared to H-2 receptor antagonists. Further research is needed to determine the benefits of stress ulcer prophylaxis in critical care settings.
AMERICAN JOURNAL OF MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Weiguo Fan, Hualong Liu, Yang Shen, Kui Hong
Summary: This study aimed to investigate the association between proton pump inhibitors (PPIs) treatment and QT interval prolongation in critically ill patients. Analysis of ECG reports of ICU patients revealed that PPIs treatment was significantly associated with an increased risk of QT interval prolongation compared to histamine 2 receptor antagonists (H2RAs) and non-acid suppression therapy (non-AST).
CARDIOVASCULAR DRUGS AND THERAPY
(2023)
Article
Pharmacology & Pharmacy
Carly Boyd, Tanna Hassig, Robert MacLaren
Summary: This study evaluated the effectiveness and safety of PPIs compared to H2RAs for preventing CIGB in mechanically ventilated patients. PPIs were associated with CIGB and higher hospital mortality rates compared to H2RAs. Further research is needed to identify appropriate selection criteria for ulcer prophylaxis.
Review
Pharmacology & Pharmacy
Jiangbi Li, Xiaoping Xie, Weibing Liu, Feng Gu, Ke Zhang, Zilong Su, Qiangqiang Wen, Zhenjiang Sui, Pengcheng Zhou, Tiecheng Yu
Summary: PPIs alone may increase the risk of fracture in children and young adults, but the combination of PPIs and H2RAs or H2RAs alone do not show significant risks. Clinicians should be cautious when prescribing PPIs to patients.
FRONTIERS IN PHARMACOLOGY
(2021)
Article
Critical Care Medicine
Dina Ali, Megan E. Barra, Joseph Blunck, Gretchen M. Brophy, Caitlin S. Brown, Meghan Caylor, Sarah L. Clark, David Hensler, Mathew Jones, Amanda Lamer-Rosen, Melissa Levesque, Leana N. Mahmoud, Sherif H. Mahmoud, Casey May, Keith Nguyen, Nicholas Panos, Christina Roels, Justin Shewmaker, Keaton Smetana, Jessica Traeger, Aric Shadler, Aaron M. Cook
Summary: The study found that the incidence of clinically important GI bleeding in aSAH patients was approximately 4.9%, with acid suppressant agents reducing the risk of GI bleeding. Specific risk factors associated with GI bleeding included elevated intracranial pressure, creatinine clearance < 60 ml/min, and cerebral vasospasm.
NEUROCRITICAL CARE
(2021)
Article
Cardiac & Cardiovascular Systems
Juntao Xie, Qingui Chen, Dejian He
Summary: This study investigated the association between pre-existing proton pump inhibitor (PPI) use before emergency department (ED) visit and short-term prognosis of acute myocardial infarction (AMI) patients. The results showed that PPI use was not associated with hospital mortality and length of ICU stay, but was associated with longer length of hospital stay and lower proportion of being admitted to ICU.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Endocrinology & Metabolism
Katherine A. Staines, Katherine Myers, Kirsty Little, Stuart H. Ralston, Colin Farquharson
Summary: Studies have shown that proton pump inhibitors may affect bone health by inhibiting the activity of the bone-specific phosphatase PHOSPHO1 and matrix mineralization, providing a potential mechanism for the increased risk of fractures associated with these widely used drugs.
CALCIFIED TISSUE INTERNATIONAL
(2021)
Article
Pharmacology & Pharmacy
Shaden S. Alhujilan, Mustafa S. Saeed, Abdullah Abdulaziz Alalwan
Summary: This study assessed the adherence to national stress ulcer prophylaxis (SUP) guidelines in a tertiary hospital in Saudi Arabia. The results indicated an observed overuse of anti-ulcer drugs, highlighting the need for greater adherence to guidelines to control costs and avoid unnecessary adverse effects.
SAUDI PHARMACEUTICAL JOURNAL
(2023)
Article
Gastroenterology & Hepatology
Sharon Ngwenya, Johanna Simin, Nele Brusselaers
Summary: This study investigated the association between long-term use of proton pump inhibitors (PPIs) and all-cause mortality and cause-specific mortality. The results showed that PPI use was associated with increased risks of both all-cause mortality and cause-specific mortality, and the risks increased with prolonged duration of use.
DIGESTIVE DISEASES AND SCIENCES
(2023)
Review
Immunology
Palna Mehta, Ronald G. Nahass, Luigi Brunetti
Summary: A systematic review and meta-analysis found that the use of acid-suppression medications (ASMs) during hospitalization was associated with a higher risk of recurrent Clostridioides difficile infection (CDI), especially with proton pump inhibitor (PPI) use. Further studies are needed to clarify the iatrogenic effects of ASMs, and unnecessary PPI use should be discontinued.
CLINICAL INFECTIOUS DISEASES
(2021)
Review
Medicine, General & Internal
Karen Clarke, Nicole Adler, Deepak Agrawal, Dimpal Bhakta, Suchita Shah Sata, Sarguni Singh, Arjun Gupta, Amit Pahwa, Emily Pherson, Alexander Sun, Frank Volpicelli, Hyung J. Cho
Summary: Proton pump inhibitors are widely used for the treatment of acid-related gastrointestinal disorders and stress ulcer prophylaxis. However, their use may lead to significant complications such as fractures, Clostridium difficile infection, acute kidney injury, chronic kidney disease, and hypomagnesemia. In the hospital setting, proton pump inhibitors are often overused and inappropriately continued after discharge.
AMERICAN JOURNAL OF MEDICINE
(2022)
Article
Medicine, General & Internal
Bokyung Kim, Jin-Hyung Jung, Kyungdo Han, Seungkyung Kang, Eunwoo Lee, Hyunsoo Chung, Sang Gyun Kim, Soo-Jeong Cho
Summary: This study aimed to investigate the effect of histamine-2 receptor antagonist (H2RA) and proton pump inhibitor (PPI) use on the positivity rate and clinical outcomes of COVID-19. The results showed that H2RA and PPI use was associated with a decreased risk for SARS-CoV-2 infection, but did not affect clinical outcomes. The protective effect of H2RA and PPI was not significant in patients with comorbidities such as diabetes, hypertension, and dyslipidemia.
JOURNAL OF KOREAN MEDICAL SCIENCE
(2023)
Article
Medicine, General & Internal
Won Gun Kwack
Summary: In critically ill patients using high-dose PPI for suspected GI bleeding, Esophagogastroduodenoscopy (EGD) did not show definitive clinical benefit and is not necessarily recommended. However, it is necessary to consider EGD in patients who are tolerant.