Prophylaxis for Stress-Related Gastric Hemorrhage
Authors: Ronald Fogel
Journal: Annals of Internal Medicine (1995)

Letters15 April 1995Prophylaxis for Stress-Related Gastric HemorrhageRonald Fogel, Tamir Ben-Menachem, and Robert S. BresalierRonald FogelSmithKline Beecham Pharmaceuticals, Philadelphia, PA 19101. University of California, San Francisco, San Francisco, CA 94105. Henry Ford Hospital, Detroit, MI 48202.Search for more papers by this author, Tamir Ben-MenachemSmithKline Beecham Pharmaceuticals, Philadelphia, PA 19101. University of California, San Francisco, San Francisco, CA 94105. Henry Ford Hospital, Detroit, MI 48202.Search for more papers by this author, and Robert S. BresalierSmithKline Beecham Pharmaceuticals, Philadelphia, PA 19101. University of California, San Francisco, San Francisco, CA 94105. Henry Ford Hospital, Detroit, MI 48202.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-122-8-199504150-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Cantu and Karlstadt question our conclusions because we excluded patients “at increased risk for gastrointestinal bleeding.” Our aim was to determine whether prophylaxis with sucralfate or cimetidine was more effective than placebo in the prevention of stress-related hemorrhage for patients admitted to a medical intensive care unit [1]. Thirty-six percent of our 877 patients were not eligible because gastrointestinal bleeding was detected before admission. An additional 12% of patients had a recent history of hemorrhage, which is a frequent cause for exclusion from prophylaxis studies [2, 3]. Patients at risk for gastrointestinal hemorrhage from causes other than stress-related ...References1. Ben-Menachem T, Fogel R, Patel RV, Touchette M, Zarowitz BJ, Hadzijahic N, et al. Prophylaxis for stress-related gastric hemorrhage in the medical intensive care unit. A randomized, controlled, single-blind study. Ann Intern Med. 1994; 121:568-75. Google Scholar2. Karlstadt RG, Iberti TJ, Silverstein J, Lindenberg L, Bright-Asare P, Rockhold F, et al. Comparison of cimetidine and placebo for the prophylaxis of upper gastrointestinal bleeding due to stress-related gastric mucosal damage in the intensive care unit. Journal of Intensive Care Medicine. 1990; 5:26-32. Google Scholar3. Martin LV, Booth FV, Karlstadt RG, Silverstein JH, Jacobs DM, Hampsey J, et al. Continuous intravenous cimetidine decreases stress-related upper gastrointestinal hemorrhage without promoting pneumonia. Crit Care Med. 1993; 21:19-30. Google Scholar4. Ruiz-Santana S, Ortiz E, Gonzalez B, Bolanos J, Ruiz-Santana A-J, Manzano JL. Stress-induced gastroduodenal lesions and total parenteral nutrition in critically ill patients: Frequency, complications, and the value of prophylactic treatment. A prospective, randomized study. Crit Care Med. 1991; 19:887-91. Google Scholar Author, Article, and Disclosure InformationAffiliations: SmithKline Beecham Pharmaceuticals, Philadelphia, PA 19101. University of California, San Francisco, San Francisco, CA 94105. Henry Ford Hospital, Detroit, MI 48202. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 April 1995Volume 122, Issue 8Page: 632-634KeywordsHemorrhageMedical intensive care unitsNSAIDsNutritionPopulation statisticsProphylaxisRoutes of administrationSepsisSurgeryTrauma surgery Issue Published: 15 April 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...