SCCM/ASHP — Guideline for the Prevention of Stress-Related Gastrointestinal Bleeding in Critically Ill Adults
Society of Critical Care Medicine / American Society of Health-System Pharmacists, 2024
Use pharmacologic stress-ulcer prophylaxis in critically ill adults with meaningful bleeding-risk factors, reassess the indication as risk changes, and stop prophylaxis when critical illness or relevant risk factors resolve. Mechanical ventilation or systemic corticosteroid use alone should not be treated as an automatic universal indication.
Clinical Context & Relevant Topics (4)
Disease ReferenceAcute, diffuse inflammatory lung injury causing hypoxemia and bilateral infiltrates not fully explained by cardiac failure or fluid overload.
Complete clinical topic overview. For the full 10-level interactive course, visit Master MV. Covers core ventilator modes, respiratory mechanics (Cstat, Raw, driving pressure), waveform dyssynchrony analysis, VILI prevention, and liberation protocols.
Risk-stratified non-variceal and variceal hemorrhage care: resuscitation, selective airway protection, individualized transfusion, PPI or portal-pressure therapy, endoscopic hemostasis, and escalation to IR/TIPS/surgery when indicated.
Phased energy and protein delivery, early enteral nutrition when safe, indirect calorimetry, refeeding prevention, feeding-intolerance troubleshooting, and individualized parenteral nutrition timing.