Contact : [email protected] Stress ulcer is common complication in patients admitted to the intensive care unit (ICU). Stress ulcer prophylaxis (SUP) is recommended for many of them, criteria for the initiation are often ignored by clinicians. SUP might be erroneously continued after ICU or even hospital discharge. Background Jitka Piubellini 1 , Antoine Schneider 2 , Philippe Eckert 2 , Farshid Sadeghipour 1,3 , Pierre Voirol 1,3 1 Pharmacy, CHUV, Lausanne, 2 Adult ICU, CHUV, Lausanne, 3 EPGL, Section of pharmaceutical Sciences, University of Geneva, University of Lausanne To describe the frequency of the SUP prescription in our adult ICU and to determine its adequacy with local guidelines. To determine the proportion of patients still receiving SUP on ICU and hospital discharge. Objectives SUP was inappropriate (not indicated or forgotten) in around 2/3 of the PD. Moreover the prescription was maintained for many patients on ICU discharge. SUP guidelines and the need for a daily reevaluation in particular at the end of the ICU stay should be reminded to the prescribers. Discussion and conclusion • Retrospective study conducted in the 35-beds adult medico-surgical ICU in CHUV • Medical records of patients admitted between October 1st and November 30th 2017 were screened. • Exclusion criteria : length of stay shorter than 24 hours or patients admitted for a gastrointestinal pathology. • The adequacy of the SUP prescription was assessed on a day-to-day basis, according to our local guidelines. • The continuation of SUP at ICU and hospital discharge was assessed. Method Among the 372 patients admitted during the study period, 140 (corresponding to 855 patient days (PD)) fulfilled inclusion criteria. Results References 1. Critical Care and Resuscitation, Vol : 18, Issue: 4, Dec 2016, Page: 270-274 2. Journal of critical care, ISSN: 1557-8615, Vol: 29, Issue: 6, Page: 955-60 SUP, Criteria 30% SUP, no Criteria 63% no SUP, no Criteria 5% no SUP, Criteria 2% Fig 2: Adequacy of the SUP prescritption (n tot 855 PD) Fig 3: Proportion o f type of SUP prescribed (n tot 796 PD) Fig 1 : Proportion of patients receiving SUP 140 130 58 39 pts fulfiled inclusion criteria pts received a SUP during ICU stay pts with SUP prescribed on ICU discharge pts with SUP prescription on hospital discharge 100% 93% 45% 30% ranitidine, 108 esomeprazole and ranitidine, 2 esomeprazole, 686 Poster N° 4CPS-004 Pertinence of the prescription of stress ulcer prophylaxis in intensive care medicine Barcelona 2019

Pertinence of the prescription of stress ulcer prophylaxis ... · Stress ulcer is common complication in patients admitted to the intensive care unit (ICU). Stress ulcer prophylaxis

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Page 1: Pertinence of the prescription of stress ulcer prophylaxis ... · Stress ulcer is common complication in patients admitted to the intensive care unit (ICU). Stress ulcer prophylaxis

Contact : [email protected]

Stress ulcer is common complication in patients admitted to the intensive care unit (ICU). Stress ulcer prophylaxis (SUP) is recommended for many of them, criteria for the initiation are often ignored by clinicians. SUP might be erroneously continued after ICU or even hospital discharge.

Background

Jitka Piubellini1, Antoine Schneider2, Philippe Eckert2, Farshid Sadeghipour1,3, Pierre Voirol1,3

1 Pharmacy, CHUV, Lausanne, 2Adult ICU, CHUV, Lausanne, 3EPGL, Section of pharmaceutical Sciences, University of Geneva, University of Lausanne

To describe the frequency of the SUP prescription in our adult ICU and to determine its adequacy with local guidelines.

To determine the proportion of patients still receiving SUP on ICU and hospital discharge.

Objectives

SUP was inappropriate (not indicated or forgotten) in around 2/3 of the PD. Moreover the prescription was maintained for many patients on ICU discharge. SUP guidelines and the need for a daily reevaluation in particular at the end of the ICU stay should be reminded to the prescribers.

Discussion and conclusion

• Retrospective study conducted in the 35-beds adult medico-surgical ICU in CHUV

• Medical records of patients admitted between October 1st and November 30th 2017 were screened.

• Exclusion criteria : length of stay shorter than 24 hours or patients admitted for a gastrointestinal pathology.

• The adequacy of the SUP prescription was assessed on a day-to-day basis, according to our local guidelines.

• The continuation of SUP at ICU and hospital discharge was assessed.

Method

Among the 372 patients admitted during the study period, 140 (corresponding to 855 patient days (PD)) fulfilled inclusion criteria.

Results

References1. Critical Care and Resuscitation, Vol : 18, Issue: 4, Dec 2016, Page: 270-2742. Journal of critical care, ISSN: 1557-8615, Vol: 29, Issue: 6, Page: 955-60

SUP, Criteria

30%

SUP, no Criteria

63%

no SUP, no Criteria

no SUP, Criteria

Fig 2: Adequacy of the SUP prescritption (ntot 855 PD)

Fig 3: Proportion o f type of SUP prescribed (ntot 796 PD)Fig 1 : Proportion of patients receiving SUP

140130

pts fulfiledinclusion criteria

pts received a SUPduring ICU stay

pts with SUPprescribed on ICU