Efficacy and safety of proton pump inhibitors and Histamine-2-receptor antagonists for stress ulcer prophylaxis in critically ill patients: a meta-analysis of randomized trials
ZHANG Hong, YUAN Jian, YU Xiangli, YE lin, YANG Chunmei
Outpatient Department, the Third Medical Center of PLA General Hospital,Beijing100039 ,China
Abstract：Objective To compare the curative effect and safety of proton pump inhibitors (PPI) and histamine-2-receptor antagonists (H2RAs) when used to prevent stress ulcer prophylaxis in critically ill patients.Methods Randomized controlled trials (RCTs) of PPI vs H2RA for stress ulcer prophylaxis in patients in critical condition were retrieved from the Cochrane library, PubMed, Embase, Science Direct,CNKI and CMB databases. Key indexes included gastrointestinal (GI) bleeding, iatrogenic pneumonia, Clostridium difficile infection, mortality and length of stay in the ICU.Results Prophylactic application of PPIs can reduce the risk of clinical gastrointestinal bleeding and upper gastrointestinal bleeding compared with H2RA.Conclusions PPIs are superior to H2RAs in preventing GI bleeding without significantly increasing the risk of pneumonia or mortality. However,their impact on Clostridium difficile infections remains uncertain.
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2019, Vol. 30 
