Society of Critical Care Medicine and American Society of Health-System Pharmacists Guideline for the Prevention of Stress-Related Gastrointestinal Bleeding in Critically Ill Adults

Factors that likely increase risk of clinically important stress-related upper gastrointestinal bleeding (UGIB): coagulopathy, shock, chronic liver disease; no firm evidence for mechanical ventilation alone as a risk factor

Enteral nutrition probably reduces UGIB risk

All critically ill adults with factors that likely increase stress-related UGIB risk should receive either proton pump inhibitors or histamine-2 receptor antagonists, at low dosage regimens, to prevent UGIB

Discontinue prophylaxis when critical illness is no longer evident or the risk factor(s) is no longer present despite ongoing critical illness

Discontinue stress ulcer prophylaxis before transfer out of the ICU to prevent inappropriate prescribing