ICU sedation, delirium & recovery
Recommendations for Stress Ulcer Prophylaxis in Critically Ill Adults: A Contextualized Clinical Practice Guideline From the Saudi Critical Care Society and the Scandinavian Society of Anaesthesiology and Intensive Care Medicine, Endorsed by the Kuwait Anesthesia and Critical Care Society
Methodological detailsGRADE-ADOLOPMENT, contextualized, Source guideline: 2024 SCCM and ASHP guideline, evaluated for credibility, contextual fit and alignment with GRADE
- GRADE-ADOLOPMENT
- Contextualized
- Source guideline: 2024 SCCM and ASHP guideline, evaluated for credibility, contextual fit and alignment with GRADE
Recommendations
As issued by the authors
- conditional recommendation; moderate certainty
In critically ill adults with coagulopathy, shock or chronic liver disease, suggest stress ulcer prophylaxis (SUP) over no SUP
- conditional recommendation; very low certainty
In enterally fed patients at high risk of upper gastrointestinal bleeding (UGIB), suggest SUP over no SUP
- conditional recommendation; very low certainty
In enterally fed patients at low risk of UGIB, suggest not using SUP
- conditional recommendation; low to moderate certainty
For patients receiving SUP, suggest a proton pump inhibitor (PPI) or H2RA rather than sucralfate
- conditional recommendation; very low to low certainty
Suggest enteral or IV administration based on clinical feasibility
- best practice statement; not GRADEd
In critically ill adults receiving SUP, use low-dose PPI or H2RA rather than high-dose regimens
- conditional recommendations; very low certainty
Suggest discontinuing SUP in critically ill adults with resolved risk factors for UGIB
- conditional recommendations; very low certainty
Suggest discontinuing SUP in critically ill adults without UGIB risk factors but receiving SUP before intensive care unit (ICU) admission in the absence of an active indication
Original publication
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