Stress Gastritis Prophylaxis
Stress Gastritis Prophylaxis
David Ray Velez, MD
Table of Contents
Also Referred to as “Stress Ulcer Prophylaxis” (SUP) or “GI Prophylaxis”
See Also:
*GI Bleeding
Indications
Guidelines are Highly Variable and Debated
Highest Risk Factors: Coagulopathy and Prolonged Mechanical Ventilation
2008 EAST Guidelines
- Level 1 Recommendations:
- Mechanical Ventilation
- Coagulopathy
- Traumatic Brain Injury
- Major Burn Injury
- Level 2 Recommendations:
- Muti-Trauma
- Sepsis
- Acute Renal Failure
- Level 3 Recommendations:
- ISS > 15
- High-Dose Steroids (> 250 mg Hydrocortisone or Equivalent per Day)
General Indications
- Major Criteria:
- Coagulopathy (INR > 1.5 or Plt < 50,000)
- Mechanical Ventilation > 48 Hours (Especially if Not Taking Enteral Nutrition)
- History of GI Ulcer or Bleed Within the Last Year
- Traumatic Brain Injury
- Spinal Cord Injury
- Severe Burn Injury (TBSA > 35%)
- Minor Criteria (≥ 2):
- Sepsis
- ICU Stay > 1 Week
- Occult GI Bleeding for ≥ 6 Days
- Steroid Therapy
- Additional Possible Criteria:
- Chronic Liver Failure
- Partial Hepatectomy
- NSAIDs
- Antiplatelet Agents
- Major Surgery
- Multiple Organ Failure
- GCS < 10
- Hypotension
- Myocardial Infarction
- Multiple Organ Failure
Enteral Nutrition: Pharmacologic Stress Ulcer Prophylaxis is Considered Unnecessary and Not Beneficial if Patient is Tolerating Enteral Nutrition and May Increase the Risk of Nosocomial Pneumonia
- Debated and Some Still Prefer to Use SUP in High-Risk Patients
Agents
Effects: Decreased Risk of Stress Ulcers, GI Bleeding, and Clinically Significant GI Bleeding
- No Effect on Mortality or ICU Length of Stay
Agents
- Proton Pump Inhibitor (PPI)
- Agents:
- Pantoprazole (Protonix) – 40 mg Daily PO or IV
- 40 mg BID in the Setting of Confirmed GI Bleeding
- Omeprazole (Prilosec) – 40 mg Daily PO
- Pantoprazole (Protonix) – 40 mg Daily PO or IV
- Mechanism: Irreversibly Blocks H/K ATPase Pump
- Agents:
- Histamine-2 Receptor Antagonist (H2 Blocker)
- Agents:
- Famotidine (Pepcid) – 20-40 mg BID PO or IV
- Mechanism: Blocks H2 Receptors on Parietal Cells
- Agents:
Oral and IV Effects are Equivalent
Comparison
- PPIs are Generally Preferred
- PPIs are More Effective than H2 Blockers
- PPIs Do Not Require Dose Adjustment for Renal Failure
- H2 Blockers Can Be Associated with Delirium
- No Significant Difference in Most Side Effects
Side Effects
- Increased Risk of Nosocomial Pneumonia (Debated)
- Increased Risk of Clostridioides difficile Infection (Debated)
- Increased Risk of Delirium with H2 Blockers