Original Article
Risk Factors for Gastrointestinal Bleeding in Critically Ill Patients
N Engl J Med 1994; 330:377-381February 10, 1994
- Abstract
Background
The efficacy of prophylaxis against stress ulcers in preventing gastrointestinal bleeding in critically ill patients has led to its widespread use. The side effects and cost of prophylaxis, however, necessitate targeting preventive therapy to those patients most likely to benefit.
Methods
We conducted a prospective multicenter cohort study in which we evaluated potential risk factors for stress ulceration in patients admitted to intensive care units and documented the occurrence of clinically important gastrointestinal bleeding (defined as overt bleeding in association with hemodynamic compromise or the need for blood transfusion).
Results
Of 2252 patients, 33 (1.5 percent; 95 percent confidence interval, 1.0 to 2.1 percent) had clinically important bleeding. Two strong independent risk factors for bleeding were identified: respiratory failure (odds ratio, 15.6) and coagulopathy (odds ratio, 4.3). Of 847 patients who had one or both of these risk factors, 31 (3.7 percent; 95 percent confidence interval, 2.5 to 5.2 percent) had clinically important bleeding. Of 1405 patients without these risk factors, 2 (0.1 percent; 95 percent confidence interval, 0.02 to 0.5 percent) had clinically important bleeding. The mortality rate was 48.5 percent in the group with bleeding and 9.1 percent in the group without bleeding (P<0.001).
Conclusions
Few critically ill patients have clinically important gastrointestinal bleeding, and therefore prophylaxis against stress ulcers can be safely withheld from critically ill patients unless they have coagulopathy or require mechanical ventilation.
Media in This Article
Table 1
Characteristics of 2828 Eligible Patients Admitted to an Intensive Care Unit.Table 2
Indications for Prophylaxis against Stress Ulcer in 674 Patients Admitted to an Intensive Care Unit.Article Activity
- Article
Gastrointestinal bleeding due to stress ulceration is an important complication in critically ill patients1,2. Prophylactic measures such as neutralization of gastric acid, reduction of gastric acid secretion, or cytoprotection are commonly recommended, on the basis of the positive results of randomized trials3-15. A recent meta-analysis reported a 50 percent reduction in the relative risk of clinically important bleeding among patients receiving prophylaxis16.
Prophylaxis against stress ulcers, however, is expensive17 and may have adverse effects,18 and the risk of clinically important bleeding has decreased during the past decade independently of the use of prophylaxis1,19-21. We undertook this prospective study to determine the incidence of clinically important gastrointestinal bleeding in a heterogeneous group of critically ill patients and to identify patients at sufficiently low risk of bleeding to obviate the need for prophylaxis.
Methods
Study Design
Consecutive patients more than 16 years old who were hospitalized between June 1990 and July 1991 at four university-affiliated medical-surgical intensive care units were considered for enrollment. Patients were ineligible if they had upper gastrointestinal bleeding (hematemesis, a nasogastric aspirate containing gross blood or “coffee grounds” material, hematochezia, or melena) within 48 hours before or 24 hours after admission, previous total gastrectomy, facial trauma or epistaxis, brain death, or a hopeless prognosis or if they died or were discharged within 24 hours after admission. Limited resources at three centers forced us to enroll subgroups of patients chosen by random allocation and to close enrollment on weekends during part of the study period.
We encouraged the attending physicians to withhold prophylaxis against stress ulcers in all patients21 except those with head injury, burns over more than 30 percent of the body-surface area, organ transplants, an endoscopic or radiographic diagnosis of peptic ulcer or gastritis in the preceding six weeks, or upper gastrointestinal bleeding three days to six weeks before admission. Prophylaxis against stress ulcers was defined as the administration of two or more doses of histamine H2-receptor antagonists, antacids, sucralfate, prostaglandin analogues, or omeprazole.
We recorded the age, sex, admitting diagnosis, and score on the Acute Physiology and Chronic Health Evaluation (APACHE II)22 scale of all eligible patients within 24 hours after admission. Daily evaluations included assessment for sepsis (defined as the presence of a core temperature >38.5 °C [>101.3 °F] or <35.0 °C [<95.0 °F], a white-cell count >15,000 per cubic millimeter or <3000 per cubic millimeter, and a positive blood culture); hypotension (either a systolic blood pressure <80 mm Hg for 2 hours or more or a decrease of ≥ 30 mm Hg in the systolic blood pressure); renal failure (a creatinine clearance rate <40 ml per minute, oliguria [<500 ml of urine per day], or a serum creatinine concentration >2.8 mg per deciliter [248 μmol per liter]); coagulopathy (a platelet count <50,000 per cubic millimeter, an International Normalized Ratio of >1.5 [i.e., prothrombin time >1.5 times the control value], or a partial-thromboplastin time >2.0 times the control value); hepatic failure (any two of the following: a serum bilirubin concentration >8.8 mg per deciliter [150 μmol per liter], a serum aspartate aminotransferase level >500 U per liter, a serum albumin level <41 g per liter, and clinical signs and symptoms of hepatic coma); the presence of a Glasgow coma score <5; administration of heparin or warfarin sodium, glucocorticoids (>200 mg of hydrocortisone or the equivalent per day), aspirin, or another nonsteroidal antiinflammatory drug; respiratory failure (a need for mechanical ventilation for at least 48 hours); the use of active enteral feeding; and the use of prophylaxis against stress ulceration (two or more doses).
The end points we studied16,21 were overt bleeding (defined as hematemesis, gross blood or “coffee grounds” material in a nasogastric aspirate, hematochezia, or melena) and clinically important bleeding. Clinically important bleeding was defined as overt bleeding complicated by one of the following within 24 hours after the onset of bleeding (in the absence of other causes): a spontaneous decrease of more than 20 mm Hg in the systolic blood pressure; an increase of more than 20 beats per minute in the heart rate, or a decrease of more than 10 mm Hg in the systolic blood pressure measured on sitting up; or a decrease in the hemoglobin level of more than 2 g per deciliter (1.2 mmol per liter) and subsequent transfusion, after which the hemoglobin did not increase by a value defined as the number of units transfused minus 2 g per deciliter. These criteria were applied independently by three outcome adjudicators who were not involved in patient care; disagreements were resolved by repeated reviews or by a fourth adjudicator.
Statistical Analysis
We conducted a forward stepwise logistic-regression analysis of the 12 potential risk factors evaluated daily, plus the following variables: age; APACHE score; head injury; multiple trauma; receipt of a transplant; status one week or less after a cardiovascular, thoracic, abdominal, pelvic, orthopedic, neurosurgical, or peripheral vascular procedure; surface burn; peptic ulcer or gastritis within six weeks of admission to the intensive care unit; and upper gastrointestinal bleeding three days to six weeks before admission. Variables that were significantly associated (P<0.05) with clinically important bleeding in a simple regression analysis were entered into a multiple logistic-regression analysis and tested for interaction. The analysis was repeated for the subgroup of patients who did not receive prophylaxis. All statistical tests were two-tailed.
Results
Of the 3241 patients admitted to intensive care units during the study, 413 were ineligible. Among these 413 patients, 227 had upper gastrointestinal bleeding (77 had hematemesis, 77 had grossly bloody nasogastric aspirates, 37 had nasogastric aspirates containing “coffee grounds” material, 18 had hematochezia, and 18 had melena), 25 had previously undergone total gastrectomy, 32 had facial trauma, 6 had epistaxis, 10 were brain-dead, and 113 had a hopeless prognosis. An additional 538 patients were admitted when resources were insufficient to enroll all patients; among them 299 were admitted on a weekend. Another 38 patients died or were discharged from the intensive care unit within 24 hours after admission. The characteristics of the remaining 2252 eligible patients are shown in Table 1Table 1
Characteristics of 2828 Eligible Patients Admitted to an Intensive Care Unit..Of these 2252 patients, 674 received prophylaxis against stress ulcers. Their sex distribution and APACHE scores were similar to those of the other 1578 patients, but they were slightly younger (59 vs. 60 years, P = 0.02), had longer stays in the intensive care unit (eight vs. three days, P<0.001), and had higher mortality (16.8 percent vs. 6.7 percent, P<0.001). The indications for prophylaxis against stress ulcers are shown in Table 2Table 2
Indications for Prophylaxis against Stress Ulcer in 674 Patients Admitted to an Intensive Care Unit.. The prophylactic treatment was an H2-receptor antagonist in 71.8 percent of the cases, sucralfate in 7.0 percent, antacids in 4.9 percent, a prostaglandin in 0.6 percent, omeprazole in 0.3 percent, and a combination of drugs in 15.4 percent. The median number of days of prophylaxis was as follows: H2-receptor antagonists, 2 days; sucralfate, 3 days; antacids, 2 days; prostaglandin, 1 day; omeprazole, 1 day; and multiple agents, 10 days. Of the 23 patients who bled while receiving prophylactic treatment, 3 bled within three days, 7 between three and seven days, and 13 more than one week after prophylaxis was started.Of the 2252 patients, 100 had overt bleeding episodes (4.4 percent; 95 percent confidence interval, 3.6 to 5.6 percent); 87 of these 100 patients were receiving prophylaxis. Thirty-three patients had clinically important bleeding (1.5 percent; 95 percent confidence interval, 1.0 to 2.1 percent); 23 of them (69.7 percent) were receiving prophylaxis. Gastrointestinal bleeding occurred a mean (±SD) of 14 ±12 days after admission to the intensive care unit. The age, sex distribution, and APACHE scores were similar in the patients who had clinically important bleeding and those who did not (Table 3Table 3
Characteristics of 2252 Patients Admitted to an Intensive Care Unit, According to the Presence or Absence of Clinically Important Bleeding after Admission.). The mortality rate among the patients with clinically important bleeding was 48.5 percent, as compared with 9.1 percent for all other patients (P<0.001) (Table 3). Agreement among the adjudicators on the presence of overt as opposed to clinically important bleeding was 81 percent after the first review and 100 percent after the second review. Agreement was 100 percent on the sources of bleeding.Among the 33 patients with clinically important bleeding, 19 had endoscopic documentation of the site of bleeding, and the site was seen at surgery in 3 other patients. The sources of bleeding in the 22 patients in whom a cause was identified were esophageal erosions (3 patients) or gastric erosions (8 patients, 3 of whom also had esophageal erosions); esophageal (1 patient), gastric (9 patients), or duodenal (7 patients) ulcers (a total of 11 patients had ulcers); esophageal and gastric varices (1 patient); Dieulafoy's vascular anomaly (1 patient); and an ileostomy anastomosis (1 patient). No upper gastrointestinal source was identified in 11 patients. Stress ulceration was present in the stomach and esophagus in four of eight patients in whom another bleeding site was identified.
The risk factors for clinically important bleeding are shown in Table 4Table 4
Risk Factors for Clinically Important Bleeding among 2252 Patients Admitted to an Intensive Care Unit.. The only independent risk factors identified in the multiple regression analysis were respiratory failure requiring mechanical ventilation for more than 48 hours (odds ratio, 15.6) and coagulopathy (odds ratio, 4.3). Among the 33 patients with clinically important bleeding, 22 had both respiratory failure and coagulopathy, 8 had respiratory failure alone, 1 had coagulopathy alone, and only 2 patients had neither (Table 5Table 5
Clinically Important Gastrointestinal Bleeding among 2252 Patients Admitted to an Intensive Care Unit, According to the Presence or Absence of Respiratory Failure and Coagulopathy.). These two factors were predictive both in patients receiving prophylaxis (odds ratios, 18.2 and 2.6, respectively) and in those not receiving prophylaxis (odds ratios, 8.9 and 7.7, respectively). The incidence of bleeding was 3.4 percent in the group receiving prophylaxis and 0.6 percent in the group that did not receive prophylaxis, suggesting that physicians were able to identify patients at higher risk for bleeding. That the proportion of patients who had one or more risk factors was 58.0 percent among those receiving prophylaxis and 28.9 percent among those not receiving prophylaxis supports this inference.Of 847 patients at high risk (i.e., those who had respiratory failure or a coagulopathy), 31 had clinically important bleeding (3.7 percent; 95 percent confidence interval, 2.5 to 5.2 percent). In contrast, only 2 of 1405 patients at low risk (those with neither risk factor) had clinically important bleeding (0.1 percent; 95 percent confidence interval, 0.02 to 0.5 percent).
Discussion
The incidence of clinically important bleeding was less than 2 percent among the 2252 patients in this study. In the only other study known to us that prospectively evaluated clinically important bleeding in critically ill adults, the incidence was 2.0 percent in a group of high-risk patients undergoing mechanical ventilation21. In addition, our results are consistent with the estimate of 2.6 percent derived from 27 randomized trials16.
The value of previous attempts to identify risk factors for bleeding caused by stress ulceration in critically ill patients was limited by their use of chart review without documentation of reproducibility23,24 and without comparison with a control group25,26. Furthermore, although three prospective cohort studies20,27,28 and six randomized trials4,6,29-32 sought risk factors for either occult or overt bleeding, the relative risk associated with individual variables was not quantified. In only three studies in adults20,21,28 and one in children33 was the independent contribution of individual risk factors explored, and as in this study, the results indicated that coagulopathy20,21,28,33 and respiratory failure20,28,33 were associated with the risk of gastrointestinal bleeding.
The most important finding of our study is that a simple decision rule predicts the risk of bleeding and allows more selective use of prophylaxis against stress ulcers, thus avoiding the unnecessary exposure of patients to potential adverse effects. Patients who did not undergo mechanical ventilation for more than 48 hours and who had no coagulopathy, who made up 62 percent of the study group, were at extremely low risk of clinically important bleeding (0.1 percent or, at worst, 0.5 percent when the upper limit of the confidence interval is considered). Of the 1405 patients in this group, 283 (20.1 percent) received prophylaxis. A conservative estimate, based on a synthesis of the available data,16 is that if none of these patients had received prophylaxis, twice the number of patients (or, at worst, 1 percent) might have had bleeding. If prophylaxis reduces this risk by 50 percent, one would need to administer prophylaxis to more than 900 low-risk patients to prevent one episode of bleeding34. These results support the view that the risk of bleeding in patients without these two risk factors is low enough that prophylaxis can be safely withheld. A decision to restrict prophylaxis to patients with at least one risk factor for bleeding would substantially reduce the use of prophylactic agents in the critically ill.
On the other hand, our results support the use of prophylaxis in the subgroup of patients in the intensive care unit who have a coagulopathy or undergo ventilation for more than 48 hours. The risk of bleeding among these patients was 3.7 percent, despite the fact that more than half received prophylactic therapy of some type. Again applying the results of the meta-analysis, which showed a reduction of approximately 50 percent in the risk of clinically important bleeding with prophylaxis,16 and assuming that this benefit applies to all relevant subgroups, we estimate that almost twice as many of these patients would have bled if prophylaxis had been withheld, and that only about 30 high-risk patients would have to receive prophylaxis to prevent one episode of clinically important bleeding.
We think that the large heterogeneous cohort of critically ill patients that we studied, the reproducible classification of clinically important bleeding, and the precision of our estimates should provide confidence that the conclusions of this study can be applied to most critically ill patients.
Supported by the Ontario Ministry of Health. Dr. Cook is a St. Joseph's Foundation Research Scholar. Drs. Cook and Guyatt are Career Scientists of the Ontario Ministry of Health.
We are indebted to the staff of the McMaster University Methods Center who made this study possible: Susan Troyan, B.A., Peggy Austin, Suzanne Duschenne, Humaira Khan, B.A., Brenda Reeve, B.Sc., Sandie Reeve, B.A., Jennifer Whyte, B.A., and Diane VanderSchee, B.A.; to the study research nurses, including Lori Bell, Carolyn Dengate, Debra Foster, Denise Geroux, Margie Johnson, Susan Langdon, Helen Mason, John Mazzalo, Janet Shields, Maria Van Buroptedem, and Nancy Wells, for their dedication to this project; to all the participating physicians for their support; and to Debbie Maddock, Dawna Jaworsky, and Barbara Hill for assistance in the preparation of the manuscript.
Source Information
From the Faculty of Health Sciences, McMaster University, Hamilton, Ont. (D.J.C., H.D.F., G.H.G., L.G., A.W.); Toronto General Hospital and the University of Toronto, Toronto (J.C.M., T.L.W., T.J.R.T.); University Hospital and the University of Western Ontario, London, Ont. (D.L.); Victoria General Hospital and Dalhousie University, Halifax, N.S. (F.R.); Victoria General Hospital and the University of Western Ontario, London, Ont. (R.H., P.R.); and Hopital Ste.-Justine and the Universite de Montreal, Montreal (J.L.) -- all in Canada. In addition to the authors, the participants in the Canadian Critical Care Trials Group were as follows: Project Group -- H. Fuller and P. Powles, Hamilton, Ont., J. Lacroix, Montreal, J. Marshall, Toronto, T. Noseworthy, Edmonton, Alta., and L. Oppenheimer, Winnipeg, Man.; Outcome Review Committee -- D. Cook, H. Fuller, J. Hewson, J. Lang, H. Lee, and P. Powles, Hamilton, Ont., B. Guslits, Detroit, M. Heule and T. Noseworthy, Edmonton, Alta., J. Lacroix, Montreal, and J. Marshall and T. Todd, Toronto; Data Monitoring -- P. Powles, Hamilton, Ont.
Address reprint requests to Dr. Cook at the Department of Medicine, Division of Critical Care, St. Joseph's Hospital, 50 Charlton Ave. E., Hamilton, ON L8N 4A6, Canada.
- References
References
1
Shuman RB ,Schuster DP ,Zuckerman GR . Prophylactic therapy for stress ulcer bleeding: a reappraisal. Ann Intern Med 1987;106:562-567
Web of Science | Medline2
Gottlieb JE ,Menashe PI ,Cruz E . Gastrointestinal complications in critically ill patients: the intensivists' overview. Am J Gastroenterol 1986;81:227-238
Web of Science | Medline3
Zinner MJ ,Zuidema GD ,Smith PL ,Mignosa M . The prevention of upper gastrointestinal tract bleeding in patients in an intensive care unit. Surg Gynecol Obstet 1981;153:214-220
Web of Science | Medline4
Basso N ,Bagarani M ,Materia A ,Fiorani S ,Lunardi P ,Speranza V . Cimetidine and antacid prophylaxis of acute upper gastrointestinal bleeding in high risk patients: controlled, randomized trial. Am J Surg 1981;141:339-341
CrossRef | Web of Science | Medline5
Friedman CJ ,Oblinger MJ ,Suratt PM , et al. Prophylaxis of upper gastrointestinal hemorrhage in patients requiring mechanical ventilation. Crit Care Med 1982;10:316-319
Web of Science | Medline6
Hastings PR ,Skillman JJ ,Bushnell LS ,Silen W . Antacid titration in the prevention of acute gastrointestinal bleeding: a controlled, randomized trial in 100 critically ill patients. N Engl J Med 1978;298:1041-1045
Full Text | Web of Science | Medline7
Khan F ,Parekh A ,Patel S ,Chitkara R ,Rehman M ,Goyal R . Results of gastric neutralization with hourly antacids and cimetidine in 320 intubated patients with respiratory failure. Chest 1981;79:409-412
CrossRef | Web of Science | Medline8
McAlhany JC Jr ,Colmic L ,Czaja AJ ,Pruitt BA Jr . Antacid control of complications from acute gastroduodenal disease after burns. J Trauma 1976;16:645-648
CrossRef | Web of Science | Medline9
Pinilla JC ,Oleniuk FH ,Reed D ,Malik B ,Laverty WH . Does antacid prophylaxis prevent upper gastrointestinal bleeding in critically ill patients? Crit Care Med 1985;13:646-650
CrossRef | Web of Science | Medline10
Stothert JC Jr ,Simonowitz DA ,Dellinger EP , et al. Randomized prospective evaluation of cimetidine and antacid control of gastric pH in the critically ill. Ann Surg 1980;192:169-174
CrossRef | Web of Science | Medline11
Weigelt JA ,Aurbakken CM ,Gewertz BL ,Snyder WH III . Cimetidine vs antacid in prophylaxis for stress ulceration. Arch Surg 1981;116:597-601
Web of Science | Medline12
Borrero E ,Ciervo J ,Chang JB . Antacid vs sucralfate in preventing acute gastrointestinal tract bleeding in abdominal aortic surgery: a randomized trial in 50 patients. Arch Surg 1986;121:810-812
Web of Science | Medline13
Borrero E ,Bank S ,Margolis IB ,Schulman ND ,Chardavoyne R . Comparison of antacid and sucralfate in the prevention of gastrointestinal bleeding in patients who are critically ill. Am J Med 1985;79:Suppl 2C:62-64
CrossRef | Web of Science | Medline14
Noseworthy TW ,Shustack A ,Johnston RG ,Anderson BJ ,Konopad E ,Grace M . A randomized clinical trial comparing ranitidine and antacids in critically ill patients. Crit Care Med 1987;15:817-819
CrossRef | Web of Science | Medline15
Laggner AN ,Lenz K ,Graninger W , et al. Strebbluntungsprophylaxe auf einer internen Intensivstation: Sucralfat versus Ranitidin. Anaesthesist 1988;37:704-710
Web of Science | Medline16
Cook DJ ,Witt LG ,Cook RJ ,Guyatt GH . Stress ulcer prophylaxis in the critically ill: a meta-analysis. Am J Med 1991;91:519-527[Erratum, J Med 1991;91:670.]
CrossRef | Web of Science | Medline17
Lacroix J ,Infante-Rivard C ,Gauthier M . Upper-gastrointestinal-bleeding (UGIB) prophylaxis: a decision-making analysis and cost/benefit analysis. Clin Invest Med 1986;9:Suppl:A22-A22 abstract.
Web of Science18
Driks MR ,Craven DE ,Celli BR , et al. Nosocomial pneumonia in intubated patients given sucralfate as compared with antacids or histamine type 2 blockers. N Engl J Med 1987;317:1376-1382
Full Text | Web of Science | Medline19
Poleski MH ,Spanier AH . Cimetidine versus antacids in the prevention of stress erosions in critically ill patients. Am J Gastroenterol 1986;81:107-111
Web of Science | Medline20
Schuster DP ,Rowley H ,Feinstein S ,McGue MK ,Zuckerman GR . Prospective evaluation of the risk of upper gastrointestinal bleeding after admission to a medical intensive care unit. Am J Med 1984;76:623-630
CrossRef | Web of Science | Medline21
Cook DJ ,Pearl RG ,Cook RJ ,Guyatt GH . The incidence of clinically important bleeding in ventilated patients. J Intensive Care Med 1991;6:167-17422
Knaus WA ,Draper EA ,Wagner DP ,Zimmerman JE . APACHE II: a severity of disease classification system. Crit Care Med 1985;13:818-829
CrossRef | Web of Science | Medline23
Tryba M ,Huchzermeyer H ,Torok M ,Zenz M ,Pahlow J . Single drug and combined medication with cimetidine, antacids and pirenzipine in the prophylaxis of acute upper gastrointestinal bleeding. Hepatogastroenterology 1983;30:154-157
Web of Science | Medline24
Harris SK ,Bone RC ,Ruth WE . Gastrointestinal hemorrhage in patients in a respiratory intensive care unit. Chest 1977;72:301-304
CrossRef | Web of Science | Medline25
Goodman AA ,Frey CF . Massive upper gastrointestinal hemorrhage following surgical operations. Ann Surg 1968;167:180-184
CrossRef | Web of Science | Medline26
Fogelman MJ ,Garvey JM . Acute gastroduodenal ulceration incident to surgery and disease: analysis and review of eighty-eight cases. Am J Surg 1966;112:651-656
CrossRef | Web of Science | Medline27
Skillman JJ ,Bushnell LS ,Goldman H ,Silen W . Respiratory failure, hypotension, sepsis, and jaundice: a clinical syndrome associated with lethal hemorrhage from acute stress ulceration of the stomach. Am J Surg 1969;117:523-530
CrossRef | Web of Science | Medline28
Kamada T ,Fusamoto H ,Kawano S ,Noguchi M ,Hiramatsu K . Gastrointestinal bleeding following head injury: a clinical study of 433 cases. J Trauma 1977;17:44-47
CrossRef | Web of Science | Medline29
van den Berg B ,van Blankenstein M . Prevention of stress-induced upper gastrointestinal bleeding by cimetidine in patients on assisted ventilation. Digestion 1985;31:1-8
CrossRef | Web of Science | Medline30
Priebe HJ ,Skillman JJ ,Bushnell LS ,Long PC ,Silen W . Antacid versus cimetidine in preventing acute gastrointestinal bleeding: a randomized trial in 75 critically ill patients. N Engl J Med 1980;302:426-430
Full Text | Web of Science | Medline31
Groll A ,Simon JB ,Wigle RD ,Taguchi K ,Todd RJ ,Depew WT . Cimetidine prophylaxis for gastrointestinal bleeding in an intensive care unit. Gut 1986;27:135-140
CrossRef | Web of Science | Medline32
Tryba M ,Zevounou F ,Torok M ,Zenz M . Prevention of acute stress bleeding with sucralfate, antacids, or cimetidine: a controlled study with pirenzepine as a basic medication. Am J Med 1985;79:Suppl 2C:55-61
CrossRef | Web of Science | Medline33
Lacroix J ,Nadeau D ,Laberge S ,Gauthier M ,Lapierre G ,Farrell CA . Frequency of upper gastrointestinal bleeding in a pediatric intensive care unit. Crit Care Med 1992;20:35-42
CrossRef | Web of Science | Medline34
Laupacis A ,Sackett DL ,Roberts RS . An assessment of clinically useful measures of the consequences of treatment. N Engl J Med 1988;318:1728-1733
Full Text | Web of Science | Medline
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Ishaq Lat, David R. Foster, Brian Erstad. (2010) Drug-induced acute liver failure and gastrointestinal complications. Critical Care Medicine 38, S175-S187
CrossRef30
F.H. Klebl. (2010) Gastrointestinale Blutungen bei Intensivpatienten. Intensivmedizin und Notfallmedizin 47:4, 260-265
CrossRef31
David C. Metz, Gerard J. Fulda, Keith M. Olsen, John T. Monyak, Steven G. Simonson, M.B. Sostek. (2010) Intravenous esomeprazole pharmacodynamics in critically ill patients. Current Medical Research and Opinion 26:5, 1141-1148
CrossRef32
Maria Jose Solana, Jesús López-Herce. (2010) Pharmacokinetics of intravenous omeprazole in critically ill paediatric patients. European Journal of Clinical Pharmacology 66:4, 323-330
CrossRef33
Pei-Chin Lin, Chia-Hsuin Chang, Ping-I Hsu, Pi-Lai Tseng, Yaw-Bin Huang. (2010) The efficacy and safety of proton pump inhibitors vs histamine-2 receptor antagonists for stress ulcer bleeding prophylaxis among critical care patients: A meta-analysis. Critical Care Medicine 38:4, 1197-1205
CrossRef34
Ludovic Reveiz, Rafael Guerrero-Lozano, Angela Camacho, Lina Yara, Paola Andrea Mosquera. (2010) Stress ulcer, gastritis, and gastrointestinal bleeding prophylaxis in critically ill pediatric patients: A systematic review. Pediatric Critical Care Medicine 11:1, 124-132
CrossRef35
G. Offenstadt, E. Maury. 2010. Prévention des hémorragies gastroduodénales de stress. , 267-275.
CrossRef36
Kevin A. Ghassemi, Thomas O. G. Kovacs, Dennis M. Jensen. (2009) Gastric acid inhibition in the treatment of peptic ulcer hemorrhage. Current Gastroenterology Reports 11:6, 462-469
CrossRef37
Cristina B. Terzi Coelho, Desanka Dragosavac, João S. Coelho Neto, Ciro G. Montes, Fábio Guerrazzi, Nelson Adami Andreollo. (2009) Ranitidine is unable to maintain gastric pH levels above 4 in septic patients. Journal of Critical Care 24:4, 627.e7-627.e13
CrossRef38
Jacob G. Hoover, Annabel L. Schumaker, Kevin J. Franklin. (2009) Use of Intravenous Proton-Pump Inhibitors in a Teaching Hospital Practice. Digestive Diseases and Sciences 54:9, 1947-1952
CrossRef39
Matthew R. Morrell, Scott T. Micek, Marin H. Kollef. (2009) The Management of Severe Sepsis and Septic Shock. Infectious Disease Clinics of North America 23:3, 485-501
CrossRef40
James M. Mullin, Melissa Gabello, Lisa J. Murray, Christopher P. Farrell, Jillan Bellows, Kevin R. Wolov, Keith R. Kearney, David Rudolph, James J. Thornton. (2009) Proton pump inhibitors: actions and reactions. Drug Discovery Today 14:13-14, 647-660
CrossRef41
Stefan Rauch, Kristine Krueger, Alparslan Turan, Norbert Roewer, Daniel I. Sessler. (2009) Determining small intestinal transit time and pathomorphology in critically ill patients using video capsule technology. Intensive Care Medicine 35:6, 1054-1059
CrossRef42
Tauseef Ali, Richard F. Harty. (2009) Stress-Induced Ulcer Bleeding in Critically Ill Patients. Gastroenterology Clinics of North America 38:2, 245-265
CrossRef43
Alex Mejia, Walter K Kraft. (2009) Acid peptic diseases: pharmacological approach to treatment. Expert Review of Clinical Pharmacology 2:3, 295-314
CrossRef44
Jean-Pierre Quenot, Nadiejda Thiery, Saber Barbar. (2009) When should stress ulcer prophylaxis be used in the ICU?. Current Opinion in Critical Care 15:2, 139-143
CrossRef45
Charity Wip, Lena Napolitano. (2009) Bundles to prevent ventilator-associated pneumonia: how valuable are they?. Current Opinion in Infectious Diseases 22:2, 159-166
CrossRef46
Matthew C. Byrnes, Greg J. Beilman. (2009) Adjunctive Measures for Treating Surgical Infections and Sepsis. Surgical Clinics of North America 89:2, 349-363
CrossRef47
Tanja Müller, Alan N Barkun, Myriam Martel. (2009) Non-Variceal Upper GI Bleeding in Patients Already Hospitalized for Another Condition. The American Journal of Gastroenterology 104:2, 330-339
CrossRef48
John C. Marshall, Deborah J. Cook. (2009) Investigator-led clinical research consortia: The Canadian Critical Care Trials Group. Critical Care Medicine 37:Supplement, S165-S172
CrossRef49
Marc Bardou, Janet Martin, Alan Barkun. (2009) Intravenous Proton Pump Inhibitors. Drugs 69:4, 435-448
CrossRef50
Jitladda Deerojanawong, Danayawan Peongsujarit, Boosba Vivatvakin, Nuanchan Prapphal. (2009) Incidence and risk factors of upper gastrointestinal bleeding in mechanically ventilated children. Pediatric Critical Care Medicine 10:1, 91-95
CrossRef51
Ji Hyun Kim, Jeong Seop Moon, Sam Ryong Jee, Woon Geon Shin, Soo-Heon Park, , . (2009) Guidelines of Treatment for Peptic Ulcer Disease in Special Conditions. The Korean Journal of Gastroenterology 54:5, 318
CrossRef52
Jeremy M. Kahn, Gordon D. Rubenfeld, Jeffery Rohrbach, Barry D. Fuchs. (2008) Cost Savings Attributable to Reductions in Intensive Care Unit Length of Stay for Mechanically Ventilated Patients. Medical Care 46:12, 1226-1233
CrossRef53
Nick Lansdale, Richard Hill, Stephen W. Hancock, Mike Thomson, Sean Marven. (2008) Stress-related mucosal disease in childhood appendicitis. Pediatric Surgery International 24:11, 1219-1222
CrossRef54
Nancy M. Tofil, Kim W. Benner, M. Paige Fuller, Margaret K. Winkler. (2008) Histamine 2 receptor antagonists vs intravenous proton pump inhibitors in a pediatric intensive care unit: A comparison of gastric pH. Journal of Critical Care 23:3, 416-421
CrossRef55
Catherine E Murphy, Alison M Stevens, Nicholas Ferrentino, Bruce A Crookes, James C Hebert, Carter B Freiburg, Jill A Rebuck. (2008) Frequency of Inappropriate Continuation of Acid Suppressive Therapy After Discharge in Patients Who Began Therapy in the Surgical Intensive Care Unit. Pharmacotherapy 28:8, 968-976
CrossRef56
Anne M. Larson. (2008) Acute Liver Failure. Disease-a-Month 54:7, 457-485
CrossRef57
Samantha Westwell. (2008) Implementing a ventilator care bundle in an adult intensive care unit. Nursing in Critical Care 13:4, 203-207
CrossRef58
Loren Laine, Koji Takeuchi, Andrzej Tarnawski. (2008) Gastric Mucosal Defense and Cytoprotection: Bench to Bedside. Gastroenterology 135:1, 41-60
CrossRef59
Peter J. Pronovost, Sean M. Berenholtz, Christine Goeschel, Irie Thom, Sam R. Watson, Christine G. Holzmueller, Julie S. Lyon, Lisa H. Lubomski, David A. Thompson, Dale Needham, Robert Hyzy, Robert Welsh, Gary Roth, Joseph Bander, Laura Morlock, J. Bryan Sexton. (2008) Improving patient safety in intensive care units in Michigan. Journal of Critical Care 23:2, 207-221
CrossRef60
Georges Offenstadt, Eric Maury. (2008) Upper gastrointestinal bleeding in severe sepsis. Critical Care Medicine 36:6, 1990-1991
CrossRef61
Lewis Somberg, John Morris, Richard Fantus, Jay Graepel, Brian G. Field, Richard Lynn, Robyn Karlstadt. (2008) Intermittent Intravenous Pantoprazole and Continuous Cimetidine Infusion: Effect on Gastric pH Control in Critically Ill Patients at Risk of Developing Stress-Related Mucosal Disease. The Journal of Trauma: Injury, Infection, and Critical Care 64:5, 1202-1210
CrossRef62
David A. Edelman, Krupa R. Patel, James G. Tyburski, Lisa G. Hall Zimmerman. (2008) Intravenous pantoprazole utilization in a level 1 trauma center. Surgical Endoscopy 22:4, 967-973
CrossRef63
F.H. Klebl, J. Schölmerich. (2008) Future expectations in the prophylaxis of intestinal bleeding. Best Practice & Research Clinical Gastroenterology 22:2, 373-387
CrossRef64
Y. Ber, M. Muñoz, C. Sostres. (2008) Gastritis agudas y crónicas. Medicine - Programa de Formación Médica Continuada Acreditado 10:2, 89-94
CrossRef65
Michael J. Levy, Louis M. Wong Kee Song, Michael B. Farnell, Sanjay Misra, Michael G. Sarr, Christopher J. Gostout. (2008) Endoscopic Ultrasound (EUS)-Guided Angiotherapyof Refractory Gastrointestinal Bleeding. The American Journal of Gastroenterology 103:2, 352-359
CrossRef66
R. Phillip Dellinger, Mitchell M. Levy, Jean M. Carlet, Julian Bion, Margaret M. Parker, Roman Jaeschke, Konrad Reinhart, Derek C. Angus, Christian Brun-Buisson, Richard Beale, Thierry Calandra, Jean-Francois Dhainaut, Herwig Gerlach, Maurene Harvey, John J. Marini, John Marshall, Marco Ranieri, Graham Ramsay, Jonathan Sevransky, B. Taylor Thompson, Sean Townsend, Jeffrey S. Vender, Janice L. Zimmerman, Jean-Louis Vincent. (2008) Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008. Intensive Care Medicine 34:1, 17-60
CrossRef67
Vandana Boparai, Jaishree Rajagopalan, George Triadafilopoulos. (2008) Guide to the Use of Proton Pump Inhibitors in Adult Patients. Drugs 68:7, 925-947
CrossRef68
D. Pateron, J.-L. Pourriat, N. Carbonell. (2008) Emorragie digestive non traumatiche dell???adulto. EMC - Anestesia-Rianimazione 13:4, 1-10
CrossRef69
R Phillip Dellinger, Mitchell M. Levy, Jean M. Carlet, Julian Bion, Margaret M. Parker, Roman Jaeschke, Konrad Reinhart, Derek C. Angus, Christian Brun-Buisson, Richard Beale, Thierry Calandra, Jean-Francois Dhainaut, Herwig Gerlach, Maurene Harvey, John J. Marini, John Marshall, Marco Ranieri, Graham Ramsay, Jonathan Sevransky, B Taylor Thompson, Sean Townsend, Jeffrey S. Vender, Janice L. Zimmerman, Jean-Louis Vincent. (2008) Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008. Critical Care Medicine 36:1, 296-327
CrossRef70
Michal Cohen, Boris Sapoznikov, Yaron Niv. (2007) Primary and Secondary Nonvariceal Upper Gastrointestinal Bleeding. Journal of Clinical Gastroenterology 41:9, 810-813
CrossRef71
Frank H Klebl, Jürgen Schölmerich. (2007) Therapy Insight: prophylaxis of stress-induced gastrointestinal bleeding in critically ill patients. Nature Clinical Practice Gastroenterology & Hepatology 4:10, 562-570
CrossRef72
Kevin O. Hwang, Sanja Kolarov, Lee Cheng, Rebecca A. Griffith. (2007) Stress ulcer prophylaxis for non-critically ill patients on a teaching service. Journal of Evaluation in Clinical Practice 13:5, 716-721
CrossRef73
Jefferson M. Sesler. (2007) Stress-related Mucosal Disease in the Intensive Care Unit. AACN Advanced Critical Care 18:2, 119-126
CrossRef74
Francesca Rubulotta, Antonino Gullo, Fulvio Iscra. (2007) Recommendations for ulcer prophylaxis in the treatment of patients with severe sepsis and septic shock: a dog chasing its tail?. Intensive Care Medicine 33:4, 718-720
CrossRef75
Todd Janicki, Scott Stewart. (2007) Stress-ulcer prophylaxis for general medical patients: A review of the evidence. Journal of Hospital Medicine 2:2, 86-92
CrossRef76
Michael J Cawley. (2007) Mechanical Ventilation: A Tutorial for Pharmacists. Pharmacotherapy 27:2, 250-266
CrossRef77
L. FISHER, A. FISHER, P. PAVLI, M. DAVIS. (2007) Perioperative acute upper gastrointestinal haemorrhage in older patients with hip fracture: incidence, risk factors and prevention. Alimentary Pharmacology & Therapeutics 25:3, 297-308
CrossRef78
Joanne Ritchie, David Sidebotham. 2007. Valvular Heart Disease. , 158-173.
CrossRef79
Dennis Bailey, V??ronique Phan, Catherine Litalien, Thierry Ducruet, Aicha M??rouani, Jacques Lacroix, France Gauvin. (2007) Risk factors of acute renal failure in critically ill children: A prospective descriptive epidemiological study*. Pediatric Critical Care Medicine 8:1, 29-35
CrossRef80
N.M. Popovic. (2007) Značaj profilakse akutne mukozne lezije kod pacijenata u jedinici intenzivnog lečenja. Acta chirurgica iugoslavica 54:1, 47-50
CrossRef81
A.D. Sijacki, N.M. Popovic, A.R. Karamarkovic, B.D. Stefanovic, V.R. Djukic, Z.D. Lausevic, S.N. Krstic, V.M. Bumbasirevic, P.D. Gregoric, B.D. Stefanovic, Dj.D. Bajec, V.M. Jeremic. (2007) Risk factors for bleeding from stress ulcer in severely injured and critically ill persons. Acta chirurgica iugoslavica 54:1, 77-81
CrossRef82
Kristen C. Sihler, Avery B. Nathens. (2006) Management of Severe Sepsis in the Surgical Patient. Surgical Clinics of North America 86:6, 1457-1481
CrossRef83
Timothy B. Gardner, Douglas J. Robertson. (2006) Stress Ulcer Prophylaxis in Non-Critically Ill Patients: Less May Be More. The American Journal of Gastroenterology 101:10, 2206-2208
CrossRef84
Jeffrey J. Bruno, Todd W. Canada. (2006) Daily Sedative Interruption in Mechanically Ventilated Patients: Limited Data, Numerous Concerns. Hospital Pharmacy 41:10, 943-951
CrossRef85
Jeremy M Kahn. (2006) Understanding economic outcomes in critical care. Current Opinion in Critical Care 12:5, 399-404
CrossRef86
Jeremy M. Kahn, Jason N. Doctor, Gordon D. Rubenfeld. (2006) Stress ulcer prophylaxis in mechanically ventilated patients: integrating evidence and judgment using a decision analysis. Intensive Care Medicine 32:8, 1151-1158
CrossRef87
Hemant Shyam Agarwal, Kevin Bernard Churchwell, John Brooke Pietsch, Cheryl Ann Little. (2006) Hemorrhagic stress ulceration in a case of appendicitis. Journal of Pediatric Surgery 41:8, 1483-1485
CrossRef88
Joshua D. Liberman, Chad T. Whelan. (2006) BRIEF REPORT: Reducing Inappropriate Usage of Stress Ulcer Prophylaxis Among Internal Medicine Residents. A Practice-Based Educational Intervention. Journal of General Internal Medicine 21:5, 498-500
CrossRef89
Lin Ying, Adam Harris, Mingying Ying, Yan Kang, Chuanxin Luo, Xinsheng Xue, Taixiang Wu. 2006. Prophylaxis for stress-related gastrointestinal bleeding. .
CrossRef90
Richard F. Harty, Hari B. Ancha. (2006) Stress ulcer bleeding. Current Treatment Options in Gastroenterology 9:2, 157-166
CrossRef91
Scott A. Flanders, Harold R. Collard, Sanjay Saint. (2006) Nosocomial pneumonia: State of the science. American Journal of Infection Control 34:2, 84-93
CrossRef92
Mohammed A. Qadeer, Joel E. Richter, Daniel J. Brotman. (2006) Hospital-acquired gastrointestinal bleeding outside the critical care unit: Risk factors, role of acid suppression, and endoscopy findings. Journal of Hospital Medicine 1:1, 13-20
CrossRef93
Marie Yeo, Tae Young Oh, Yong Seok Kim, Young Mi Won, Sung Whan Ahn, Jin Kim, Soon Ki Chung, Myung Hee Chung, Sung Uk Han, Ki-Baik Hahm. (2006) Identification of Molecular Targets Associated with Augmented Gastric Mucosal Damages after Stress in the Presence of Helicobacter Pylori Using High Throughput Analysis of cDNA Microarray and Proteomics. Journal of Clinical Biochemistry and Nutrition 38:2, 77-93
CrossRef94
Thomas J. Nuckton, Brett H. Holko, Sean A. McKay, Jeffrey M. Newman. (2006) The Institute for Healthcare Improvement ventilator bundle: definitions, summary, and brief review of the evidence. Journal of Organ Dysfunction 2:1, 48-52
CrossRef95
P. N. MATON. (2005) Review article: prevention of stress-related mucosal bleeding with proton-pump inhibitors. Alimentary Pharmacology and Therapeutics 22:s3, 45-52
CrossRef96
Ruth Armano, France Gauvin, Thierry Ducruet, Jacques Lacroix. (2005) Determinants of red blood cell transfusions in a pediatric critical care unit: A prospective, descriptive epidemiological study*. Critical Care Medicine 33:11, 2637-2644
CrossRef97
Megan Robertson. (2005) Helicobacter pylori and stress ulceration: An ongoing puzzle*. Critical Care Medicine 33:7, 1650-1652
CrossRef98
Eric Maury, Jacques Tankovic, Anne Ebel, Georges Offenstadt. (2005) An observational study of upper gastrointestinal bleeding in intensive care units: Is Helicobacter pylori the culprit?*. Critical Care Medicine 33:7, 1513-1518
CrossRef99
Frank H. Klebl, Nicole Bregenzer, Lars Schöfer, Wolfgang Tamme, Julia Langgartner, Jürgen Schölmerich, Helmut Messmann. (2005) Comparison of inpatient and outpatient upper gastrointestinal haemorrhage. International Journal of Colorectal Disease 20:4, 368-375
CrossRef100
Gourang P. Patel, Joshua Liberman, David Gurka, Ellen Elpern, Robert A. Balk. (2005) Complications of Critical Illness. Clinical Pulmonary Medicine 12:4, 258-268
CrossRef101
Jean-Louis Vincent. (2005) Give your patient a fast hug (at least) once a day*. Critical Care Medicine 33:6, 1225-1229
CrossRef102
Julie Polson, William M. Lee. (2005) AASLD position paper: The management of acute liver failure. Hepatology 41:5, 1179-1197
CrossRef103
Chun-Che Lin, Yi-Chia Lee, Huei Lee, Jaw-Town Lin, Wei-Chi Ho, Tan-Hsia Chen, Hsiu-Po Wang. (2005) Bedside colonoscopy for critically ill patients with acute lower gastrointestinal bleeding. Intensive Care Medicine 31:5, 743-746
CrossRef104
A. Kalenka, T. Hauguth, D. Olenik, F. Fiedler. (2005) Use of Proton Pump Inhibitors (PPI) for prevention of gastrointestinal bleeding in ICU patients. European Journal of Anaesthesiology 22:Supplement 34, 163
CrossRef105
Alan D. Baxter, Jill Allan, Johane Bedard, Sue Malone-Tucker, Sharon Slivar, Mike Langill, Marc Perreault, Owen Jansen. (2005) Adherence to simple and effective measures reduces the incidence of ventilator-associated pneumonia. Canadian Journal of Anesthesia/Journal canadien d'anesthésie 52:5, 535-541
CrossRef106
D. A. Zink, M. Pohlman, M. Barnes, M. E. Cannon. (2005) Long-term use of acid suppression started inappropriately during hospitalization. Alimentary Pharmacology and Therapeutics 21:10, 1203-1209
CrossRef107
J. Schölmerich, J. Langgartner. (2005) Störungen des Verdauungstraktes bei kritisch Kranken. Intensivmedizin + Notfallmedizin 42:4, 317-336
CrossRef108
Steven A. Conrad, Andrea Gabrielli, Benjamin Margolis, Andrew Quartin, J Steven Hata, William O. Frank, Robert G. Bagin, James A. Rock, Bonnie Hepburn, Loren Laine. (2005) Randomized, double-blind comparison of immediate-release omeprazole oral suspension versus intravenous cimetidine for the prevention of upper gastrointestinal bleeding in critically ill patients. Critical Care Medicine 33:4, 760-765
CrossRef109
Julie A. Haizlip, Ralph A. Lugo, Jared J. Cash, Donald D. Vernon. (2005) Failure of nasogastric omeprazole suspension in pediatric intensive care patients. Pediatric Critical Care Medicine 6:2, 182-187
CrossRef110
Neil Stollman, David C. Metz. (2005) Pathophysiology and prophylaxis of stress ulcer in intensive care unit patients. Journal of Critical Care 20:1, 35-45
CrossRef111
Stig Bengmark. 2005. Fiber (Prebiotics) and Probiotics. , 151-171.
CrossRef112
Sripathi R. Kethu, Geoffrey C. Davis, Steven E. Reinert, Usman C. Ramzan, Steven F. Moss. (2005) Low Utility of Endoscopy for Suspected Upper Gastrointestinal Bleeding Occurring in Hospitalized Patients. Southern Medical Journal 98:2, 170-175
CrossRef113
Joseph S. Solomkin. (2005) Ventilator-associated pulmonary infection: the germ theory of disease remains viable. Microbes and Infection 7:2, 279-291
CrossRef114
David C. Metz. (2005) Preventing the gastrointestinal consequences of stress-related mucosal disease. Current Medical Research and Opinion 21:1, 11-18
CrossRef115
Frank Klebl, Nicole Bregenzer, Lars Sch
fer, Wolfgang Tamme, Julia Langgartner, J
CrossRef116
Didier Dreyfuss. (2004) Beyond randomized, controlled trials. Current Opinion in Critical Care 10:4, 574-578
CrossRef117
Stephen Trzeciak, R Phillip Dellinger. (2004) Other supportive therapies in sepsis: An evidence-based review. Critical Care Medicine 32:Supplement, S571-S577
CrossRef118
Ryan J. Daley, Jill A. Rebuck, Lynda S. Welage, Frederick B. Rogers. (2004) Prevention of stress ulceration: Current trends in critical care. Critical Care Medicine 32:10, 2008-2013
CrossRef119
Nalini M Guda, Michelle Noonan, Mary Jane Kreiner, Susan Partington, Nimish Vakil. (2004) Use of Intravenous Proton Pump Inhibitors in Community Practice: An Explanation for the Shortage?. The American Journal of Gastroenterology 99:7, 1233-1237
CrossRef120
William D. Schweickert, Brian K. Gehlbach, Anne S. Pohlman, Jesse B. Hall, John P. Kress. (2004) Daily interruption of sedative infusions and complications of critical illness in mechanically ventilated patients*. Critical Care Medicine 32:6, 1272-1276
CrossRef121
H. Isobe, K. Okajima, N. Harada, W. Liu, H. Okabe. (2004) Activated protein C reduces stress-induced gastric mucosal injury in rats by inhibiting the endothelial cell injury. Journal of Thrombosis and Haemostasis 2:2, 313-320
CrossRef122
Mitchell J. Spirt. (2004) Stress-related mucosal disease: Risk factors and prophylactic therapy. Clinical Therapeutics 26:2, 197-213
CrossRef123
Rajeev Jain. 2004. Stress Ulceration. , 466-468.
CrossRef124
Mitchell J. Spirt. (2003) Acid Suppression in Critically Ill Patients: What Does the Evidence Support?. Pharmacotherapy 23:10 Part 2, 87S-93S
CrossRef125
MASAHIKO INAMORI, JUN-ICHI TOGAWA, HIROKAZU TAKAHASHI, MASATO YONEDA, NOBUTAKA FUJISAWA, TOMOYUKI IWASAKI, YUTAKA OZAWA, TAISUKE KIKUCHI, KENICHI MURAMATSU, GAKU CHIGUCHI, SHUHEI MATSUMOTO, HARUNOBU KAWAMURA, YASUNOBU ABE, HIROYUKI KIRIKOSHI, NORITOSHI KOBAYASHI, TAKASHI SAKAGUCHI, TOMOO TAKAMURA, ATSUSHI NAKAJIMA, NORIO UENO, HISAHIKO SEKIHARA. (2003) Comparison of the effect on intragastric pH of a single dose of omeprazole or rabeprazole: Which is suitable for on-demand therapy?. Journal of Gastroenterology and Hepatology 18:9, 1034-1038
CrossRef126
J Hiramoto. (2003) Evidence-based analysis: postoperative gastric bleeding: etiology and prevention. Surgical Oncology 12:1, 9-19
CrossRef127
M. Sabovic. (2003) Tranexamic acid is beneficial as adjunctive therapy in treating major upper gastrointestinal bleeding in dialysis patients. Nephrology Dialysis Transplantation 18:7, 1388-1391
CrossRef128
F. Parente, C. Cucino, S. Gallus, S. Bargiggia, S. Greco, L. Pastore, G. Bianchi Porro. (2003) Hospital use of acid-suppressive medications and its fall-out on prescribing in general practice: a 1-month survey. Alimentary Pharmacology and Therapeutics 17:12, 1503-1506
CrossRef129
Donald R Duerksen. (2003) Stress-related mucosal disease in critically ill patients. Best Practice & Research Clinical Gastroenterology 17:3, 327-344
CrossRef130
David S. Oh, Joseph R. Pisegna. (2003) Pharmacologic treatment of upper gastrointestinal bleeding. Current Treatment Options in Gastroenterology 6:2, 157-162
CrossRef131
Jos?? A. Tantale??n, Rosa J. Le??n, Alejandro A. Santos, Eduardo S??nchez. (2003) Multiple organ dysfunction syndrome in children*. Pediatric Critical Care Medicine 4:2, 181-185
CrossRef132
Mitchell J. Spirt. (2003) Stress-related mucosal disease. Current Treatment Options in Gastroenterology 6:2, 135-145
CrossRef133
Pinak S. Acharya, David A. Lipson. (2003) Gastrointestinal Complications of Acute Respiratory Failure. Clinical Pulmonary Medicine 10:2, 80-84
CrossRef134
L Ying, A Harris, M Ying, Y Kang, C Luo, X Xue, Lin Ying. 2003. Prophylaxis for stress-related gastrointestinal bleeding. .
CrossRef135
Dincer Yildizdas, Hacer Yapicioglu, Hayri Levent Yilmaz. (2002) Occurrence of ventilator-associated pneumonia in mechanically ventilated pediatric intensive care patients during stress ulcer prophylaxis with sucralfate, ranitidine, and omeprazole. Journal of Critical Care 17:4, 240-245
CrossRef136
Akiko Shiotani, David Y Graham. (2002) Pathogenesis and therapy of gastric and duodenal ulcer disease. Medical Clinics of North America 86:6, 1447-1466
CrossRef137
Daren K. Heyland, Deborah J. Cook, Peter M. Dodek. (2002) Prevention of ventilator-associated pneumonia: Current practice in Canadian intensive care units. Journal of Critical Care 17:3, 161-167
CrossRef138
Deborah Cook, Roy Brower, Jamie Cooper, Laurent Brochard, Jean-Louis Vincent. (2002) Multicenter clinical research in adult critical care. Critical Care Medicine 30:7, 1636-1643
CrossRef139
Regina Kunz, Hans-Hellmut Neumayer, Khalid S. Khan. (2002) When small degrees of bias in randomized trials can mislead clinical decisions: An example of individualizing preventive treatment of upper gastrointestinal bleeding. Critical Care Medicine 30:7, 1503-1507
CrossRef140
M. Brian Fennerty. (2002) Pathophysiology of the upper gastrointestinal tract in the critically ill patient: Rationale for the therapeutic benefits of acid suppression. Critical Care Medicine 30:Supplement, S351-S355
CrossRef141
Kenneth P. Steinberg. (2002) Stress-related mucosal disease in the critically ill patient: Risk factors and strategies to prevent stress-related bleeding in the intensive care unit. Critical Care Medicine 30:Supplement, S362-S364
CrossRef142
Joseph R. Pisegna. (2002) Pharmacology of acid suppression in the hospital setting: Focus on proton pump inhibition. Critical Care Medicine 30:Supplement, S356-S361
CrossRef143
Brooks D. Cash. (2002) Evidence-based medicine as it applies to acid suppression in the hospitalized patient. Critical Care Medicine 30:Supplement, S373-S378
CrossRef144
David W. Noble. (2002) Proton pump inhibitors and stress ulcer prophylaxis: Pause for thought? *. Critical Care Medicine 30:5, 1175-1176
CrossRef145
Darryl Choo, Khalid Khwaja, Kenneth Nori, Michael Rewinski, Richard Zeff, George Perdrizet. (2002) In Vivo Characterization of the Molecular-Genetic Changes in Gastric Mucosa during the Development of Acute Gastritis and Stress Ulceration. The Journal of Trauma: Injury, Infection, and Critical Care 52:4, 720-726
CrossRef146
Sean M. Berenholtz, Todd Dorman, Koni Ngo, Peter J. Pronovost. (2002) Qualitative review of intensive care unit quality indicators. Journal of Critical Care 17:1, 1-12
CrossRef147
Santiago Ewig, Antoni Torres. (2002) Prevention and management of ventilator-associated pneumonia. Current Opinion in Critical Care 8:1, 58-69
CrossRef148
Stuart S. Kaufman, Elizabeth Ruby Lyden, Cindy R. Brown, Carolyn K. Davis, Deborah A. Andersen, Keith M. Olsen, Kimberly L. Bergman, Simon P. Horslen, Debra L. Sudan, Ira J. Fox, Byers W. Shaw, Alan N. Langnas. (2002) Omeprozole Therapy in Pediatric Patients After Liver and Intestinal Transplantation. Journal of Pediatric Gastroenterology and Nutrition 34:2, 194-198
CrossRef149
R KHADAROO. (2002) ARDS and the multiple organ dysfunction syndrome Common mechanisms of a common systemic process. Critical Care Clinics 18:1, 127-141
CrossRef150
C. E. van Iperen, A. van de Wiel, J. J. M. Marx. (2001) Acute event-related anaemia. British Journal of Haematology 115:4, 739-743
CrossRef151
Peter H.J. van der Voort, René W.M. van der Hulst, Durk F. Zandstra, Alfons A.M. Geraedts, Arie van der Ende, Guido N.J. Tytgat. (2001) Suppression of Helicobacter pylori infection during intensive care stay: Related to stress ulcer bleeding incidence?. Journal of Critical Care 16:4, 182-187
CrossRef152
Richard Cook, Deborah Cook, Jessica Tilley, Ker-ai Lee, John Marshall. (2001) Multiple organ dysfunction: Baseline and serial component scores. Critical Care Medicine 29:11, 2046-2050
CrossRef153
France Gauvin, Marc-Andr?? Dugas, Mahamadou Cha??bou, Sylvain Morneau, Denis Lebel, Jacques Lacroix. (2001) The impact of clinically significant upper gastrointestinal bleeding acquired in a pediatric intensive care unit. Pediatric Critical Care Medicine 2:4, 294-298
CrossRef154
Adrienne G. Randolph. (2001) Upper gastrointestinal bleeding in the pediatric intensive care unit: Clinically important but questionably preventable. Pediatric Critical Care Medicine 2:4, 349-350
CrossRef155
Keith M. Olsen, Kimberly L. Bergman, Stuart S. Kaufman, Jill A. Rebuck, Dean S. Collier. (2001) Omeprazole pharmacodynamics and gastric acid suppression in critically ill pediatric transplant patients. Pediatric Critical Care Medicine 2:3, 232-237
CrossRef156
Michael Tryba. (2001) Role of acid suppressants in intensive care medicine. Best Practice & Research Clinical Gastroenterology 15:3, 447-461
CrossRef157
Wahid Wassef, Jorge Obando, Ashish Sharma. (2001) Upper Gastrointestinal Bleeding of Nonvariceal Origin in the ICU Setting. Journal of Intensive Care Medicine 16:3, 105-113
CrossRef158
Jo Ann Brooks. (2001) Postoperative Nosocomial Pneumonia: Nurse-Sensitive Interventions. AACN Clinical Issues: Advanced Practice in Acute and Critical Care 12:2, 305-323
CrossRef159
Enrico Fiaccadori, Umberto Maggiore, Barbara Clima, Luigi Melfa, Carlo Rotelli, Alberico Borghetti. (2001) Incidence, risk factors, and prognosis of gastrointestinal hemorrhage complicating acute renal failure. Kidney International 59:4, 1510-1519
CrossRef160
Sunil G. Sheth, J. Thomas LaMont. (2001) Gastrointetinal Problems in the Chronically Critically Ill Patient. Clinics in Chest Medicine 22:1, 135-147
CrossRef161
Robert M. Rodriguez, Howard L. Corwin, Andrew Gettinger, Michael J. Corwin, Dean Gubler, Ronald G. Pearl. (2001) Nutritional deficiencies and blunted erythropoietin response as causes of the Amemia of critical illness. Journal of Critical Care 16:1, 36-41
CrossRef162
Robert MacLaren, S. Jo-Anne Wilson, Amanda Campbell, David Anderson, Graeme Rocker. (2001) Evaluation and Survey of Intravenous Vitamin K 1 for Treatment of Coagulopathy in Critically Ill Patients. Pharmacotherapy 21:2, 175-182
CrossRef163
Nancy Rayhorn, Carol Thrall, Gary Silber. (2001) A Review of the Causes of Upper Gastrointestinal Tract Bleeding in Children. Gastroenterology Nursing 24:1, 23-27
CrossRef164
R Dhôte, B Detournay, A Slama, L Hamel, M.A Bigard, P.E Bollaert, R Colin, J.Y Fagon, J.R Le Gall, J.C Raphaël. (2000) Enquête nationale sur les pratiques de prophylaxie des hémorragies gastroduodénales en réanimation. Réanimation Urgences 9:7, 550-554
CrossRef165
Robert J. Nardino, Ronald J. Vender, Peter N. Herbert. (2000) Overuse of acid-suppressive therapy in hospitalized patients1. The American Journal of Gastroenterology 95:11, 3118-3122
CrossRef166
B Raynard, B Bernard, G Bleichner, J.Y Fagon. (2000) Prévention des hémorragies digestives hautes de stress en réanimation Révision de la conférence de consensus de 1988. Réanimation Urgences 9:7, 555-560
CrossRef167
E F Wijdicks. (2000) Management of massive hemispheric cerebral infarct: is there a ray of hope?. Mayo Clinic Proceedings 75:9, 945-952
CrossRef168
Ulrich Halm, Farahnaz Halm, Joachim M??ssner. (2000) Is Helicobacter pylori Associated with Gastrointestinal Bleeding After Cardiac Surgery?. Critical Care Medicine 28:8, 3124
CrossRef169
Peter H.J. van der Voort, Durk F. Zandstra. (2000) Pathogenesis, risk factors, and incidence of upper gastrointestinal bleeding after cardiac surgery: Is specific prophylaxis in routine bypass procedures needed?. Journal of Cardiothoracic and Vascular Anesthesia 14:3, 293-299
CrossRef170
Umar Beejay, M. Michael Wolfe. (2000) ACUTE GASTROINTESTINAL BLEEDING IN THE INTENSIVE CARE UNIT. Gastroenterology Clinics of North America 29:2, 309-336
CrossRef171
M.Michael Wolfe, George Sachs. (2000) Acid suppression: Optimizing therapy for gastroduodenal ulcer healing, gastroesophageal reflux disease, and stress-related erosive syndrome. Gastroenterology 118:2, S9-S31
CrossRef172
Ulrich Halm, Farahnaz Halm, Daniela Thein, Friedrich W. Mohr, Joachim M??ssner. (2000) Helicobacter pylori infection: A risk factor for upper gastrointestinal bleeding after cardiac surgery?. Critical Care Medicine 28:1, 110-113
CrossRef173
James D. Lewis, Edward J. Shin, David C. Metz. (2000) Characterization of gastrointestinal bleeding in severely ill hospitalized patients. Critical Care Medicine 28:1, 46-50
CrossRef174
Paul G. Jodka, Stephen O. Heard. (2000) Management of the Septic Patient in the Operating Room. International Anesthesiology Clinics 38:4, 1-29
CrossRef175
Tsai, Poon, Yu, Chang, Yeh, Ko, Chen. (2000) Nasogastric lansoprazole is effective in suppressing gastric acid secretion in critically ill patients. Alimentary Pharmacology and Therapeutics 14:1, 123-127
CrossRef176
Robert M. Dettmer, Thomas H. Riley, Floyd Byfield, Peter H.R. Green. (1999) The use of intravenous H2-receptor antagonists in a tertiary care hospital. The American Journal of Gastroenterology 94:12, 3473-3477
CrossRef177
Daniel P. Schuster. (1999) Wringing blood from a turnip. Critical Care Medicine 27:12, 2846-2847
CrossRef178
Deborah Cook. (1999) Ventilator-associated pneumonia. Current Opinion in Critical Care 5:5, 350-356
CrossRef179
Marin H. Kollef. (1999) EPIDEMIOLOGY AND RISK FACTORS FOR NOSOCOMIAL PNUEMONIA. Clinics in Chest Medicine 20:3, 653-670
CrossRef180
A. Brent Carter, Douglas B. Hornick. (1999) THERAPY FOR VENTILATOR-ASSOCIATED PNEUMONIA. Clinics in Chest Medicine 20:3, 681-691
CrossRef181
Uwe Blecker, Devendra I. Mehta, Benjamin D. Gold. (1999) Pediatric gastritis and peptic ulcer disease. The Indian Journal of Pediatrics 66:5, 725-733
CrossRef182
Tamir Ben-Menachem, Robert S. Bresalier. (1999) Prophylaxis for stress-related gastrointestinal hemorrhage. Current Treatment Options in Gastroenterology 2:4, 313-319
CrossRef183
Megan S. Robertson, John F. Cade, Robert L. Clancy. (1999) Helicobacter pylori infection in intensive care. Critical Care Medicine 27:7, 1276-1280
CrossRef184
Antonios Liolios, John M. Oropello, Ernest Benjamin. (1999) GASTROINTESTINAL COMPLICATIONS IN THE INTENSIVE CARE UNIT. Clinics in Chest Medicine 20:2, 329-345
CrossRef185
Daren K. Heyland. (1999) Review of gut-specific strategies to reduce intensive care unit-acquired infections. Current Opinion in Critical Care 5:2, 132
CrossRef186
John W. Devlin, Karen S. Claire, Scott A. Dulchavsky, James G. Tyburski. (1999) Impact of Trauma Stress Ulcer Prophylaxis Guidelines on Drug Cost and Frequency of Major Gastrointestinal Bleeding. Pharmacotherapy 19:4, 452-460
CrossRef187
Kollef, Marin H., . (1999) The Prevention of Ventilator-Associated Pneumonia. New England Journal of Medicine 340:8, 627-634
Full Text188
Catherine M. Crill, Emily B. Hak. (1999) Upper Gastrointestinal Tract Bleeding in Critically Ill Pediatric Patients. Pharmacotherapy 19:2, 162-180
CrossRef189
Abdellah Aouifi, Vincent Piriou, Olivier Bastien, Pierre Joseph, Pascale Blanc, Pascal Chiari, Camille Diab, Jacques Villard, Jean Jacques Lehot. (1999) Complications digestives sévères après chirurgie cardiaque sous circulation extracorporelle. Canadian Journal of Anesthesia/Journal canadien d'anesthésie 46:2, 114-121
CrossRef190
Paul E Marik. (1999) Stress Ulcer Prophylaxis: A Practical Approach. Journal of Intensive Care Medicine 14:1, 1-8
CrossRef191
Tom E. Peddicord, Keith M. Olsen, Dean S. Collier. (1999) Effect of omeprazole, lansoprazole, and ranitidine on the DNA synthesis of mononuclear cells. Critical Care Medicine 27:1, 90-94
CrossRef192
Nancy P. Lam, Phuong-Dung T. Le, Stephanie Y. Crawford, Subhash Patel. (1999) National survey of stress ulcer prophylaxis. Critical Care Medicine 27:1, 98-103
CrossRef193
Adrienne G. Randolph, Gordon H. Guyatt, James E. Calvin, Gordon Doig, W. Scott Richardson. (1998) Understanding articles describing clinical prediction tools. Critical Care Medicine 26:9, 1603-1612
CrossRef194
Stephan Kress, Dieter Schilling, Jürgen Ferdinand Riemann. (1998) Konzept der Streßulkusprophylaxe. Medizinische Klinik 93:8, 486-491
CrossRef195
(1998) Prevention of Gastrointestinal Bleeding during Mechanical Ventilation. New England Journal of Medicine 339:4, 266-268
Full Text196
Adrienne G. Randolph, Gordon H. Guyatt, W. Scott Richardson. (1998) Prognosis in the intensive care unit. Critical Care Medicine 26:4, 767-772
CrossRef197
Cook, Deborah, Guyatt, Gordon, Marshall, John, Leasa, David, Fuller, Hugh, Hall, Richard, Peters, Sharon, Rutledge, Frank, Griffith, Lauren, McLellan, Allan, Wood, Gordon, Kirby, Ann, Tweeddale, MartinPagliarello, JoeJohnston, Richard. (1998) A Comparison of Sucralfate and Ranitidine for the Prevention of Upper Gastrointestinal Bleeding in Patients Requiring Mechanical Ventilation. New England Journal of Medicine 338:12, 791-797
Full Text198
Michael R. Lasky, Michael H. Metzler, Jeffrey O. Phillips. (1998) A Prospective Study of Omeprazole Suspension to Prevent Clinically Significant Gastrointestinal Bleeding from Stress Ulcers in Mechanically Ventilated Trauma Patients. The Journal of Trauma: Injury, Infection, and Critical Care 44:3, 527-533
CrossRef199
S. Pitimana-aree, D. Forrest, G. Brown, A. Anis, X. h. Wang, P. Dodek. (1998) Implementation of a clinical practice guideline for stress ulcer prophylaxis increases appropriateness and decreases cost of care. Intensive Care Medicine 24:3, 217-223
CrossRef200
M. H. Kollef. (1998) Improving the appropriateness and effectiveness of ICU practices. Intensive Care Medicine 24:3, 201-203
CrossRef201
Kathleen M. Neill, Kathleen T. Rice, Helen L. Ahern. (1998) Update: Assessment of Gastric pH in the Critically Ill. Worldviews on Evidence-Based Nursing E5:1, 47-57
CrossRef202
Grant E. O'Keefe, Larry M. Gentilello, Ronald V. Maier. (1998) Incidence of Infectious Complications Associated With the Use of Histamine2-Receptor Antagonists in Critically III Trauma Patients. Annals of Surgery 227:1, 120-125
CrossRef203
Ronald F. Martin, Patrick Flynn. (1997) THE ACUTE ABDOMEN IN THE CRITICALLY ILL PATIENT. Surgical Clinics of North America 77:6, 1455-1464
CrossRef204
Katherine A. Riester, Peter Peduzzi, Theodore R. Holford, Richard T. Ellison, Sam T. Donta. (1997) Statistical evaluation of the role of Helicobacter pylori in stress gastritis: Applications of splines and bootstrapping to the logistic model. Journal of Clinical Epidemiology 50:11, 1273-1279
CrossRef205
Brian L. Erstad, James M. Camamo, Michael J. Miller, Anthony M. Webber, John Fortune. (1997) Impacting cost and appropriateness of stress ulcer prophylaxis at a university medical center. Critical Care Medicine 25:10, 1678-1684
CrossRef206
William Y. Lu, Denise H. Rhoney, Warren B. Boling, John D. Johnson, Terry C. Smith. (1997) A Review of Stress Ulcer Prophylaxis in the Neurosurgical Intensive Care Unit. Neurosurgery 41:2, 416-426
CrossRef207
Holly M. Zimmerman, Kellie L. Curfman. (1997) Acute Gastrointestinal Bleeding. AACN Clinical Issues: Advanced Practice in Acute and Critical Care 8:3, 449-458
CrossRef208
Bernard, Gordon R., Wheeler, Arthur P., Russell, James A., Schein, Roland, Summer, Warren R., Steinberg, Kenneth P., Fulkerson, William J., Wright, Patrick E., Christman, Brian W., Dupont, William D., Higgins, Stanley B., Swindell, Bridget B., . (1997) The Effects of Ibuprofen on the Physiology and Survival of Patients with Sepsis. New England Journal of Medicine 336:13, 912-918
Full Text209
Anna-Leena Kuusela, Tarja Ruuska, Riitta Karikoski, Pekka Laippala, R. Sami Ikonen, Martti Janas, Markku Maki. (1997) A randomized, controlled study of prophylactic ranitidine in preventing stress-induced gastric mucosal lesions in neonatal intensive care unit patients. Critical Care Medicine 25:2, 346-351
CrossRef210
Fred Baxter. (1997) Septic Shock. Canadian Journal of Anaesthesia 44:1, 59-72
CrossRef211
Richard T. Ellison, Guillermo Perez-Perez, Carolyn H. Welsh, Martin J. Blaser, Katherine A. Riester, Alan S. Cross, Sam T. Donta, Peter Peduzzi. (1996) Risk factors for upper gastrointestinal bleeding in intensive care unit patients. Critical Care Medicine 24:12, 1974-1981
CrossRef212
Jeffrey O. Phillips, Michael H. Metzler, Major Tina L. Palmieri, Roger E. Huckfeldt, Nicola G. Dahl. (1996) A prospective study of simplified omeprazole suspension for the prophylaxis of stress-related mucosal damage. Critical Care Medicine 24:11, 1793-1800
CrossRef213
Guo-Wen Sun, Thomas L. Shook, Gregory L. Kay. (1996) Inappropriate use of bivariable analysis to screen risk factors for use in multivariable analysis. Journal of Clinical Epidemiology 49:8, 907-916
CrossRef214
Suman Kaur, Gregory Cooper, Sandra Fakult, Hillard M. Lazarus. (1996) Incidence and outcome of overt gastrointestinal bleeding in patients undergoing bone marrow transplantation. Digestive Diseases and Sciences 41:3, 598-603
CrossRef215
Tamir Ben-Menachem, Bruce D. McCarthy, Ronald Fogel, Rhett M. Schiffman, Rakesh V. Patel, Barbara J. Zarowitz, David R. Nerenz, Robert S. Bresalier. (1996) Prophylaxis for stress-related gastrointestinal hemorrhage. Critical Care Medicine 24:2, 338-345
CrossRef216
John C. Marshall, Deborah J. Cook, Nicolas V. Christou, Gordon R. Bernard, Charles L. Sprung, William J. Sibbald. (1995) Multiple Organ Dysfunction Score. Critical Care Medicine 23:10, 1638-1652
CrossRef217
Richard K. Simons, David B. Hoyt, Robert J. Winchell, Troy Holbrook, A. Brent Eastman. (1995) A Risk Analysis of Stress Ulceration after Trauma. The Journal of Trauma: Injury, Infection, and Critical Care 39:2, 289-294
CrossRef218
M. Smith, J. Bihari, D. F. Zandstra, C. P. Stoutenbeek. (1995) Bleeding from the gastrointestinal tract during prolonged ventilation. Intensive Care Medicine 21:6, 543-544
CrossRef219
W. L. PETERSON. (1995) The role of acid in upper gastrointestinal haemorrhage due to ulcer and stress-related mucosal damage. Alimentary Pharmacology & Therapeutics 9, 43-46
CrossRef220
A.B.Johan Groeneveld, Jeroen J. Kolkman. (1994) Splanchnic tonometry: a review of physiology, methodology, and clinical applications. Journal of Critical Care 9:3, 198-210
CrossRef221
(1994) Gastrointestinal Bleeding in Critically Ill Patients. New England Journal of Medicine 331:1, 51-53
Full Text222
Lesley G. King, Martha T. Stevens, Ernest N. So. Ostro, Deborah Diserens, J. Ravi Shankar. (1994) A Model For Prediction Of Survival In Critically III Dogs. Journal of Veterinary Emergency and Critical Care 4:2, 85-99
CrossRef223
Peterson, Walter L., . (1994) Prevention of Upper Gastrointestinal Bleeding. New England Journal of Medicine 330:6, 428-429
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