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GI Prophylaxis

GI Prophylaxis. Godwin Tse LA TRAP 2011. What is it for?. Stress ulcer – gastrointestinal mucosal injury related to critical illness  GI bleeding. Pathophysiology [1]. Risk Factors [2][3]. Coagulopathy Platelet count <50000mm 3 INR>1.5 PTT>2x normal Mechanical ventilation > 48 hrs.

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GI Prophylaxis

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  1. GI Prophylaxis Godwin Tse LA TRAP 2011

  2. What is it for? • Stress ulcer – gastrointestinal mucosal injury related to critical illness  GI bleeding

  3. Pathophysiology[1]

  4. Risk Factors[2][3] • Coagulopathy • Platelet count <50000mm3 • INR>1.5 • PTT>2x normal • Mechanical ventilation > 48 hrs

  5. Prophylaxis[4] • Antacids • Sucralfate • Histamine2 receptor antagonists • Proton pump inhibitors • Enteral feeding

  6. Complications[5] • Nosocomial Pneumonia • Due to elevation of gastric pH • Certain meds may increase risk of VAP

  7. Fun Fact[6]

  8. References • [1] Neligan, Patrick. Stress Ulceration in Critical Care. 2006. University of Pennsylvania. Nov 30. 2011 <http://www.ccmtutorials.com/support/ulcers/page_03.htm> • [2] Cook DJ, Fuller HD, Guyatt GH et al. Risk factors for gastrointestinal bleeding in critically ill patients. Canadian Critical Care Trials Group. N Engl J Med 1994; 330(6):377-381. • [3] Mutlu GM, Mutlu EA, Factor P. GI complications in patients receiving mechanical ventilation. American College of Chest Physicians. Chest 2001; 119(4):1222-1241. • [4]Mohebbi L, Hesch K. Stress ulcer prophylaxis in the ICU. Baylor University Medical Center Procedings. Baylor University Medical Proceedings 2009; 22(4):373-376. • [5]Miano TA, Reichert MG, Houle TT et al. Nosocomial Pneumonia Risk and Stress Ulcer Prophylaxis. American College of Chest Physicians. Chest 2009; 136:440-447. • [6] Chemistry Blog. 2010. Nov 30 2011. <http://www.chemistry-blog.com/>

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