Stress ulcer prophylaxis. Do critically ill patients need it?

Critically ill patients who have a coagulopathy or require mechanical ventilation or high-dose corticosteroids are at increased risk for significant stress-related gastrointestinal hemorrhage. Unfortunately, it is not clear that prophylaxis has any impact on the incidence of bleeding or its outcome. When preventive therapy seems warranted, sucralfate (Carafate) is a good first choice if the patient has a nasoenteric tube in place. If not, histamine2 blockers in fixed doses by either continuous infusion or bolus can be used.