Students Research in Progress
Monday, October 14, 2024
01:00 PM–02:30 PM
Abstract
Introduction:
Stress ulcers may develop in the upper gastrointestinal (GI) tract due to hypersecretion of gastric acid or impaired mucosal protection due to GI tract hypoperfusion, mucosal ischemia or disruption. There are many risk factors for developing stress ulcers, specifically mechanical ventilation, traumatic brain injury, spinal cord injury, sepsis/shock, major surgery, hypotension, certain medications, and multiple organ failure. Proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) are used as stress ulcer prophylaxis (SUP) to lower the chance of stress-related GI bleeding and complications. Long-term use of PPIs has been associated with several complications, including Clostridioides difficile infections, pneumonia, dementia, and drug interactions. While SUP has been shown to lower the risk of stress-related GI bleeding and complications, particularly in the intensive care unit (ICU), available guidelines provide no guidance on when to discontinue acid suppression. Several articles suggest SUP be discontinued once risk factors are no longer present.
Research Question or Hypothesis: Is stress ulcer prophylaxis being discontinued appropriately once patients are transferred out of the intensive care unit?
Study Design: Retrospective, single-center, observational study
Methods: A retrospective chart review was conducted to assess SUP duration. Utilization data for patients with PPIs started in the ICU and transferred to acute care were collected for the calendar year 2023. Patients were excluded if a PPI was used for any indication other than SUP. Every ninth patient was chart reviewed for a target random sample of 50 patients. Patient demographics, medication use, laboratory values and risk factors were collected. Outcomes evaluated included percentage of patients with SUP continued after transferring out of the ICU and at discharge and incidence of GI bleeding during hospitalization. Data will be analyzed with descriptive statistics.
Results: In-progress
Conclusion: In-progress
Presenting Author
Emerson Roberts B.S.Nebraska Medicine
Authors
Sara Kjerengtroen PharmD, BCPS
Nebraska Medicine
Brandon Reynolds PharmD, BCPS
University of Nebraska Medical Center
Madeline Shaffer PharmD
Nebraska Medicine