Cook DJ, Reeve BK, Guyatt GH, et al. Stress ulcer prophylaxis in critically ill patients: Resolving discordant meta-analyses. Journal of the American Medical Association. 1996;275(4):308-314.
The authors report a meta-analysis of 63 randomized trials of stress ulcer prophylaxis in critically ill patients. They find “strong evidence” of a reduction in clinically important GI bleeding with H2-receptor antagonists. They also find that sucralfate may be as effective in reducing bleeding as pH-altering drugs and is associated with lower rates of pneumonia and mortality. However, they note that the data are insufficient to determine the net effect of sucralfate compared with no prophylaxis.
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