PEPTIC

2020 Acid Suppression
? ICUs
26771 patients

Clinical Question

In ICU patients requiring invasive mechanical ventilation, does the use of proton pump inhibitors (PPIs) vs. histamine-2 receptor blockers (H2RBs) for stress-ulcer prophylaxis, reduce 90-day mortality?

Critical Appraisal

Key findings

Post-Hoc Analysis:
Difference in mortality was mostly found in the group of patients with high illness severity

Critique

There was a large proportion of crossover from the intervention arm to the control arm

Population
Adult ICU Patients
Population Details
ICU patients requiring invasive mechanical ventilation
Intervention Arms

PPI
Proton pump inhibitor

Control Arms

Histamine-2 Receptor Blocker

Primary Outcome
90 day mortality
Secondary Outcomes
Less upper GI bleeding , No difference in C. diff infections
P Value
0.9

Outcome Results

Not recorded