Critically ill patients admitted to the intensive care unit (ICU) are at risk of developing gastrointestinal (GI) bleeding owing to stress ulcers, which is associated with a prolonged length of stay (LOS) in the ICU and an increased risk of death.
- To prevent GI bleeding in these critically ill patients, ICU doctors frequently prescribe stress ulcers prophylaxis (SUP).
- Proton pump inhibitors (PPIs) and histamine type 2 receptor blockers (H2Bs) are the most commonly used SUP agents.
- Sepsis has been considered a risk factor for the development of stress ulceration and GI bleeding for many years, and SUP is recommended by the Surviving Sepsis Campaign guidelines for patients with sepsis or septic shock who have risk factors for GI bleeding.
- Although these guidelines further recommend either H2Bs or PPIs when SUP is indicated, there is limited evidence of the effects of H2Bs in comparison with PPIs when used as SUP in critically ill patients with sepsis.
- A recent meta-analysis of a general population of patients in the ICU suggested that PPIs are the most effective agents in preventing clinically important GI bleeding. However, two retrospective studies found that PPIs were associated with a higher rate of GI bleeding than H2Bs.
- In clinical practice, PPIs are more commonly prescribed by critical care providers, possibly because of their superior acid suppression capability in comparison with H2Bs.
- However, PPI use is not without risk. Some studies have shown that patients receiving PPIs have a higher risk of nosocomial pneumonia, Clostridium difficile infection(CDI), and myocardial infarction.
- Accordingly, it is reasonable to evaluate the comparative effects of SUP using PPIs and H2Bs on important outcomes in patients with severe sepsis or septic shock.
- A retrospective cohort study compares two strategies for SUP among adult patients with sepsis or septic shock who have risk factors for GI bleeding.
- Specifically, hypothesized that PPIs are associated with a lower occurrence of GI bleeding and in-hospital mortality than H2Bs but may increase the risk of pneumonia and CDI.
To learn more about Proton pump inhibitors: brainly.com/question/15605049
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Take a picture of the options
Answer:
Explanation:
'There used to be a number of theories about how the Moon was made and it was one of the aims of the Apollo program to figure out how we got to have our Moon,' says Sara.
Prior to the Apollo mission research there were three theories about how the Moon formed.
Capture theory suggests that the Moon was a wandering body (like an asteroid) that formed elsewhere in the solar system and was captured by Earth's gravity as it passed nearby. In contrast, accretion theory suggested that the Moon was created along with Earth at its formation. Finally, according to the fission scenario, Earth had been spinning so fast that some material broke away and began to orbit the planet.
What is most widely accepted today is the giant-impact theory. It proposes that the Moon formed during a collision between the Earth and another small planet, about the size of Mars. The debris from this impact collected in an orbit around Earth to form the Moon.
A is correct
B is incorrect because that is the opposite of what you should do, changing lanes should not be done over multiple lanes
C is incorrect because at an intersection, there would be solid lines on the road you could not legally, nor smoothly drive over
