The aim of this study was to determine the utilization of SRMD (stress related mucosal disease) prophylaxis in the ICU (intensive care unit) of a large teaching institution based on duration and defined adverse ef...The aim of this study was to determine the utilization of SRMD (stress related mucosal disease) prophylaxis in the ICU (intensive care unit) of a large teaching institution based on duration and defined adverse effects. Patients were reviewed for appropriateness of SRMD prophylactic therapy based on the presence of two independent risk factors (coagulopathy and mechanical ventilation greater than 48 hours) versus presence of any one risk factor from a list developed by the study investigator. Data was collected into spreadsheets and outcomes were analyzed using descriptive statistics. When evaluating patients based on the presence of any risk factor, 84 percent of patients had at least one risk factor present, while 16 percent did not have any. In patients who received famotidine, there was one occtLrrence of Clostridium difficile and 6 cases of electrolyte abnormalities. In patients who received a PPI, there was one documented case of HAP, two cases of ventilator-associated pneumonia, three cases of Clostridium difficile, and 14 patients who developed electrolyte abnormalities. Data does not show an association between acid suppression therapy and incidence of nosocomial infections. The number of patients whose therapy exceeded the appropriate stop-date compared with the number of patients in which SRMD prophylaxis was discontinued when risk factors diminished was greater when evaluating patients based upon the two independent risk factors.展开更多
文摘The aim of this study was to determine the utilization of SRMD (stress related mucosal disease) prophylaxis in the ICU (intensive care unit) of a large teaching institution based on duration and defined adverse effects. Patients were reviewed for appropriateness of SRMD prophylactic therapy based on the presence of two independent risk factors (coagulopathy and mechanical ventilation greater than 48 hours) versus presence of any one risk factor from a list developed by the study investigator. Data was collected into spreadsheets and outcomes were analyzed using descriptive statistics. When evaluating patients based on the presence of any risk factor, 84 percent of patients had at least one risk factor present, while 16 percent did not have any. In patients who received famotidine, there was one occtLrrence of Clostridium difficile and 6 cases of electrolyte abnormalities. In patients who received a PPI, there was one documented case of HAP, two cases of ventilator-associated pneumonia, three cases of Clostridium difficile, and 14 patients who developed electrolyte abnormalities. Data does not show an association between acid suppression therapy and incidence of nosocomial infections. The number of patients whose therapy exceeded the appropriate stop-date compared with the number of patients in which SRMD prophylaxis was discontinued when risk factors diminished was greater when evaluating patients based upon the two independent risk factors.