Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Less prophylactic medication in critically ill patients


Critically ill patients in intensive care units frequently receive stress-ulcer prophylaxis aiming to prevent gastrointestinal bleeding. But according to a recent major international study, in which the Inselspital participated, this prophylactic measure seems to provide fewer benefits than previously assumed.

By nature of the underlying medical condition, patients hospitalized in intensive care units are critically ill. As a physiological response to critical illness, an increased number of stress hormones is released that render the gastrointestinal tract more vulnerable to gastrointestinal bleeding.

Preparation of medication in an intensive care unit (symbolic picture: Sandra Stämpfli)

Department of Intensive Care, Inselspital, Bern University Hospital

In order to prevent this, most patients in intensive units routinely receive prophylactic medication using a “proton-pump inhibitor”. In a large clinical trial involving 33 intensive care units in 6 EU countries and Switzerland, it was now investigated whether this clinical routine indeed provides clinical benefits for critically ill patients.

The results were published in the renowned New England Journal of Medicine on 24 October 2018 and, simulaneously, made public at the annual congress of the European Society of Intensive Care Medicine in Paris.

Comparable mortality rates and complications in patients with and without prophylaxis

The large-scale clinical trial comprised about 3,300 critically ill patients treated in intensive care units. The Inselspital Bern served as Switzerland’s coordination center. Half of the patients received a proton-pump inhibitor to guard against gastrointestinal bleeding, whereas the other half was given a placebo.

After 90 days, there was no difference in mortality rates among critically ill patients treated with versus without the prophylaxis. Rates of pneumonia, certain gastrointestinal infections, or the frequencies of myocardial infarctions were comparable in both trial groups.

The number of treatment days without organ support on the intensive care unit was also similar. Thus, the researchers were unable to determine a clinical benefit for the prophylactic medication for the entirety of critically ill patients.

Prof. Dr. med. Joerg C. Schefold from the Department of Intensive Care Medicine at Inselspital Bern, who was leading the clinical trial in Switzerland, ranks the results as highly relevant for global clinical practice on intensive care units:

“Our new data suggest that most likely only few critically ill patients benefit from stress-ulcer prophylaxis. Thus, intensive care unit physicians should carefully consider whether routine use of such stress-ulcer prophylaxis is indeed indicated. This may especially be the case in vulnerable patient populations, such as in critically ill patients.”

Wissenschaftliche Ansprechpartner:

Prof. Dr. med. Joerg C. Schefold, Chief Physician, Department of Intensive Care, Inselspital, Bern University Hospital,, contact via +41 31 632 79 25.


DOI: 10.1056/NEJMoa1714919

Weitere Informationen:

Monika Kugemann | Universitätsspital Bern

More articles from Health and Medicine:

nachricht Purdue cancer identity technology makes it easier to find a tumor's 'address'
16.11.2018 | Purdue University

nachricht Microgel powder fights infection and helps wounds heal
14.11.2018 | Michigan Technological University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: UNH scientists help provide first-ever views of elusive energy explosion

Researchers at the University of New Hampshire have captured a difficult-to-view singular event involving "magnetic reconnection"--the process by which sparse particles and energy around Earth collide producing a quick but mighty explosion--in the Earth's magnetotail, the magnetic environment that trails behind the planet.

Magnetic reconnection has remained a bit of a mystery to scientists. They know it exists and have documented the effects that the energy explosions can...

Im Focus: A Chip with Blood Vessels

Biochips have been developed at TU Wien (Vienna), on which tissue can be produced and examined. This allows supplying the tissue with different substances in a very controlled way.

Cultivating human cells in the Petri dish is not a big challenge today. Producing artificial tissue, however, permeated by fine blood vessels, is a much more...

Im Focus: A Leap Into Quantum Technology

Faster and secure data communication: This is the goal of a new joint project involving physicists from the University of Würzburg. The German Federal Ministry of Education and Research funds the project with 14.8 million euro.

In our digital world data security and secure communication are becoming more and more important. Quantum communication is a promising approach to achieve...

Im Focus: Research icebreaker Polarstern begins the Antarctic season

What does it look like below the ice shelf of the calved massive iceberg A68?

On Saturday, 10 November 2018, the research icebreaker Polarstern will leave its homeport of Bremerhaven, bound for Cape Town, South Africa.

Im Focus: Penn engineers develop ultrathin, ultralight 'nanocardboard'

When choosing materials to make something, trade-offs need to be made between a host of properties, such as thickness, stiffness and weight. Depending on the application in question, finding just the right balance is the difference between success and failure

Now, a team of Penn Engineers has demonstrated a new material they call "nanocardboard," an ultrathin equivalent of corrugated paper cardboard. A square...

All Focus news of the innovation-report >>>



Industry & Economy
Event News

“3rd Conference on Laser Polishing – LaP 2018” Attracts International Experts and Users

09.11.2018 | Event News

On the brain’s ability to find the right direction

06.11.2018 | Event News

European Space Talks: Weltraumschrott – eine Gefahr für die Gesellschaft?

23.10.2018 | Event News

Latest News

Purdue cancer identity technology makes it easier to find a tumor's 'address'

16.11.2018 | Health and Medicine

Good preparation is half the digestion

16.11.2018 | Life Sciences

Microscope measures muscle weakness

16.11.2018 | Life Sciences

Science & Research
Overview of more VideoLinks >>>