Abstract:
BACKGROUND:Proton pump inhibitors (PPIs) and histamine type 2 receptor blockers (H2Bs) are used for stress ulcer prophylaxis. Although the PPIs have greater potency for acid suppression, their relative effectiveness for preventing clinically important GI bleeding (CIGIB) has not been established. The goal of this study was to determine whether prophylactic PPIs were associated with lower risk of CIGIB than H2Bs among critically ill adults. METHODS:This retrospective cohort study included adults with critical illness from January 1, 2008, to June 30, 2012, who had at least one stress ulcer risk factor and received a PPI or H2B for ≥ 3 days. Cox proportional hazards regression propensity score matching and instrumental variable analyses were used to control for selection bias and confounding by unmeasured factors. The Acute Physiology and Chronic Health Evaluation Score version IV score was used to adjust for differences of acuity. The main outcome and exposure was CIGIB. RESULTS:Among 70,093 patients at risk, 49,576 (70.7%) received prophylaxis for at least 3 days, and 424 patients (0.6%) met the definition for experiencing CIGIB. The hazard for CIGIB was two times greater for PPI users compared with H2B users (adjusted hazard ratio, 1.82 [95% CI, 1.19-2.78]; hazard ratio, 2.37 [95% CI, 1.61-3.5]). Sensitivity analyses failed to detect any plausible scenario in which PPIs were superior to H2Bs for the prevention of CIGIB. CONCLUSIONS:H2Bs were robustly and consistently associated with significantly lower CIGIB risk compared with PPIs in this population.
journal_name
Chestjournal_title
Chestauthors
Lilly CM,Aljawadi M,Badawi O,Onukwugha E,Tom SE,Magder LS,Harris Idoi
10.1016/j.chest.2018.05.015subject
Has Abstractpub_date
2018-09-01 00:00:00pages
557-566issue
3eissn
0012-3692issn
1931-3543pii
S0012-3692(18)30795-5journal_volume
154pub_type
杂志文章相关文献
CHEST文献大全abstract::Although infectious mononucleosis is usually a benign illness, life-threatening complications may occur. We describe a 17-year-old pregnant girl who developed necrotizing epiglottitis and dysphagia progressing to aspiration pneumonia and respiratory failure. The factors predisposing to this life-threatening complicati...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.96.1.204
更新日期:1989-07-01 00:00:00
abstract::The effects of erythromycin on the NADPH oxidase activity in the neutrophils of normal subjects and patients with bronchiolitis were investigated. In the patients receiving erythromycin, NADPH oxidase activity was significantly lower in a whole-cell system than that before therapy. Erythromycin was also found to inhib...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.104.4.1191
更新日期:1993-10-01 00:00:00
abstract::The American Association of Critical-Care Nurses (AACN) Standards for Establishing and Sustaining Healthy Work Environments and the American College of Chest Physicians (ACCP) Patient-Focused Care Project are complementary initiatives that provide a road map for creating practice environments where interdisciplinary, ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.130.5.1571
更新日期:2006-11-01 00:00:00
abstract::Human lung mast cells have been reported recently to contain small amounts of the elastolytic protease present in the neutrophil and implicated in the pathogenesis of alveolar wall destruction in emphysema. Since mast cells are numerous within alveolar walls, release of inflammatory mediators (and possibly elastase) b...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.94.1.119
更新日期:1988-07-01 00:00:00
abstract:STUDY OBJECTIVES:It has been suggested that sleep-disordered breathing (SDB) is a risk factor for ischemic heart disease, and may be associated with increased morbidity and mortality due to cardiovascular disease. The aim of this study was to examine the relation between nocturnal oxygen desaturation (NOD) due to SDB a...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.124.3.936
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:Data on patients with cancer who have a prolonged length of stay (LOS) in the ICU are scarce. The aim of the present study was to evaluate the characteristics and the outcomes of cancer patients with life-threatening complications with an ICU stay > or = 21 days. METHODS:A cohort study performed at a 10-bed...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-0359
更新日期:2008-09-01 00:00:00
abstract::A 60-year-old man developed histologic lesions characteristic of acute febrile neutrophilic dermatosis in skin and lung during preleukemic and leukemic phases of acute myeloid leukemia. These lesions showed improvement and resolution during oral prednisone therapy, requiring higher doses during each relapse. The respo...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.90.6.922
更新日期:1986-12-01 00:00:00
abstract:BACKGROUND:Patients with malignant pleural effusion (MPE) have limited prognoses. They require long-lasting symptom relief with minimal hospitalization. Indwelling pleural catheters (IPCs) and talc pleurodesis are approved treatments for MPE. Establishing the implications of IPC and talc pleurodesis on subsequent hospi...
journal_title:Chest
pub_type: 杂志文章,多中心研究
doi:10.1378/chest.11-2657
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND AND STUDY OBJECTIVES:Noninvasive positive airway pressure may play a significant role in treating patients with congestive heart failure (CHF). We tested our hypothesis that noninvasive bilevel positive airway pressure improves left ventricular performance in patients with chronic CHF secondary to severe sys...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.118.4.1004
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:Patients with acute respiratory symptoms still remain a diagnostic challenge. The aim of the study was to evaluate whether focused sonography could potentially diagnose life-threatening conditions missed at the primary assessment in a patient population consisting of admitted patients with acute respiratory ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.13-0882
更新日期:2013-12-01 00:00:00
abstract::A prospective study of community-acquired pneumonia in Hong Kong was carried out between January and December, 1988. Ninety adults (57 male) with a mean age of 57.3 years were admitted to the Prince of Wales Hospital with community-acquired pneumonia. The etiologic diagnosis of pneumonia was made in 37 cases (41 perce...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.101.2.442
更新日期:1992-02-01 00:00:00
abstract::Severe head injury often results in hypoxemia, but the pathophysiology of this phenomenon is unclear. We studied 24 patients hospitalized after severe head injury to determine whether the abnormality of oxygen transfer as measured by venous admixture (Qs/Qt) was associated with a reduction in functional residual capac...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.84.1.29
更新日期:1983-07-01 00:00:00
abstract::We report three cases of organophosphate (OP) poisoning. One patient was a 19-year-old woman who drank OP compounds in an attempt at suicide. The other two patients became intoxicated on the way to the hospital during mouth-to-mouth breathing. The first patient died in the emergency department, and the other two were ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.122.2.740
更新日期:2002-08-01 00:00:00
abstract::Mucoid impaction is a complication of asthma and is frequently recurrent in patients with allergic bronchopulmonary aspergillosis (ABPA). This report describes a patient with asthma and recurrent bilateral well-circumscribed densities on chest roentgenogram in the absence of ABPA. Recognition of this clinical presenta...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.98.4.1023
更新日期:1990-10-01 00:00:00
abstract:BACKGROUND:Work-related symptoms and disability due to respiratory disease are common and costly among working-age adults. To investigate this problem, we analyzed data on respiratory symptoms related to the workplace and occupational disability from the European Community Respiratory Health Survey (ECRHS). METHODS:Th...
journal_title:Chest
pub_type: 杂志文章,多中心研究
doi:
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:To determine the risk of acquiring ventilator-associated pneumonia (VAP) and the impact on costs when extending ventilator circuit change intervals beyond 2 days to 7 and 30 days. DESIGN:Prospective 4-year review of mechanically ventilated patients. SETTING:The respiratory and medical ICUs of an 800-bed ter...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.113.2.405
更新日期:1998-02-01 00:00:00
abstract::A 60-pack-year smoker presented with cough, dyspnea and orthopnea of three months' duration. Spirometry revealed severe reduction in maximal expiratory flow; CT of the chest and bronchoscopy demonstrated expiratory collapse of a mid-tracheal segment, and a presumptive diagnosis of tracheomalacia was made. A right late...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.97.4.939
更新日期:1990-04-01 00:00:00
abstract::A 72-year-old man presented with malaise, weight loss, and cough. Chest radiograph revealed bilateral pleural effusions. On thoracentesis, the left effusion was a clear yellow exudate with more than 90% lymphocytes, and the right effusion was a grossly bloody exudate with more than 90% neutrophils. Cultures of both ef...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.110.3.849
更新日期:1996-09-01 00:00:00
abstract::The alterations in metabolic (oxygen consumption [VO2] and carbon dioxide production [VCO2]) and hemodynamic (heart rate and blood pressure) parameters caused by various common intensive care activities were examined in a group of 23 mechanically-ventilated critically-ill patients. The observed variations in metabolic...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.86.6.815
更新日期:1984-12-01 00:00:00
abstract:OBJECTIVE:Symptomatic malignant pleural effusions are common sequelae in patients with certain malignancies. Pleurodesis via bedside thoracostomy is the current treatment option most commonly used. To our knowledge, this is the first prospective randomized trial to examine which agent, bleomycin or talc slurry, is supe...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.112.2.430
更新日期:1997-08-01 00:00:00
abstract::Three young men died of rapidly progressive pulmonary edema of delayed onset after inhalation of fumes from an accidental nitric acid explosion. Electron microscopy revealed altered neutrophils and necrotic endothelial cells in alveolar capillaries. Immunohistochemistry showed small and large serum proteins, including...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.97.2.487
更新日期:1990-02-01 00:00:00
abstract::A 66-year-old man with a history of COPD and Aspergillus fumigatus infection developed massive hemoptysis. Pulmonary artery angiography revealed an aneurysm which was successfully treated with coil embolization. This is the first known report of a pulmonary artery aneurysm causing massive hemoptysis in a patient with ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.113.4.1130
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVES:To investigate the feasibility of individualized workload increments, as used in adults, for exercise testing in children; and to investigate whether this individualized protocol makes it possible to satisfy the usual criteria for maximal exercise (clinical exhaustion, predicted maximum heart rate [HRmax], o...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.120.1.81
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:When evaluating peripheral pulmonary lesions, a 3.0-mm ultrathin bronchoscope (UTB) with a 1.7-mm working channel is advantageous regarding good access to the peripheral airway, whereas a 4.0-mm thin bronchoscope provides a larger 2.0-mm working channel, which allows the use of various instruments including ...
journal_title:Chest
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.chest.2019.06.038
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the acute effects of noninvasive positive pressure ventilation (NPPV) in patients with stable chronic respiratory failure secondary to cystic fibrosis. PATIENTS:Eight patients (29+/-5 years of age) with severe airflow limitation (mean FEV1, 24+/-3% predicted) and chronic respiratory failure (PaO2...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.113.4.1013
更新日期:1998-04-01 00:00:00
abstract::There has been dramatic resurgence of interest in surgical treatment of emphysema, particularly "lung volume reduction" procedures. Recent studies have demonstrated improvements in pulmonary function, lung mechanics, exercise tolerance, and quality of life in selected patients following volume reduction procedures. Ho...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.110.1.205
更新日期:1996-07-01 00:00:00
abstract::The ability of mixed venous oxygen saturation (SvO2) monitoring to reflect changes in cardiac index (CI) with therapy in critically ill patients is unclear. To this end, SvO2 and CI were measured before and during an infusion of enoximone and/or dobutamine in 30 patients with advanced heart failure. A nonlinear relati...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.99.6.1403
更新日期:1991-06-01 00:00:00
abstract:STUDY OBJECTIVES:Evidence exists that HIV-seropositive individuals may be at increased risk for the development of precocious pulmonary emphysema. HIV infection is also associated with antioxidant deficiency in both the serum and lungs, and it is therefore possible that increased oxidant stress may contribute to parenc...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.126.5.1439
更新日期:2004-11-01 00:00:00
abstract::Lung scans with technetium sulfur colloid were performed in ten patients with life-threatening hemoptysis and nondiagnostic chest roentgenograms. Localized deposition of radionuclide was demonstrated in five of the six patients who were studied during active bleeding. These abnormalities were confirmed bronchoscopical...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.86.2.208
更新日期:1984-08-01 00:00:00
abstract::The field of lung transplant has made significant advances over the last several decades. Despite these advances, morbidity and mortality remain high when compared with other solid organ transplants. As the field moves forward, the speed by which progress can be made will in part be determined by our ability to overco...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1016/j.chest.2018.08.1036
更新日期:2019-03-01 00:00:00