Meta-analysis文献Proton Pump Inhibitors vs. Histamine 2 Receptor Antagonists for Stress-Related Mucosal Bleeding Prophylaxis in Critically Ill Patients A Meta-Analysis.pdfVIP

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Meta-analysis文献Proton Pump Inhibitors vs. Histamine 2 Receptor Antagonists for Stress-Related Mucosal Bleeding Prophylaxis in Critically Ill Patients A Meta-Analysis.pdf

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nature publishing group CLINICAL AND SYSTEMATIC REVIEWS 507 CME Proton Pump Inhibitors vs. Histamine 2 Receptor W E I Antagonists for Stress-Related Mucosal Bleeding V E Prophylaxis in Critically Ill Patients: A Meta-Analysis R Alan N. Barkun, MD, MSc1,2, Marc Bardou, MD, PhD3,4, C.Q.D. Pham, PharmD5,6 and Myriam Martel, BSc1 OBJECTIVES: H2-receptor antagonists (H2RA) have been shown to reduce stress-related mucosal bleeding (SRMB), yet randomized controlled trials assessing proton pump inhibitors (PPIs) have yielded conﬂ icting results. The objective of this study was to evaluate the efﬁ cacy of PPIs vs. H2RAs in the prophylaxis of SRMB in critically ill adults with risk factors for bleeding. METHODS: Tailored literature searches of the past four decades were conducted. Outcomes measured were the decreases in rates of clinically signiﬁ cant bleeding (B, primary outcome of the meta-analysis), noso- comial pneumonia (P), and mortality (M) (secondary outcomes). Study heterogeneity was sought and