• Jeffrey J Bruno, Todd W Canada, Chris D Wakefield, and Joseph L Nates.
• Division of Pharmacy, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030-4009, USA. jjbruno@mdanderson.org
• J Oncol Pharm Pract. 2009 Mar 1; 15 (1): 9-16.

ObjectiveTo determine the incidence of stress-related mucosal bleeding (SRMB) in a critically ill oncology population receiving stress ulcer prophylaxis (SUP) with either a histamine-2 receptor antagonist (H2RA) or proton pump inhibitor (PPI).DesignSingle-center, prospective, observational study.SettingFifty-two bed medical-surgical intensive care unit of an academic oncology institution.PatientsA convenience sample of 100 medical and surgical critically ill oncology patients who received intensive care for more than 24 hours and at least one dose of a H2RA or PPI for prevention of SRMB.InterventionsNone.Measurements And Main ResultsPatients were followed throughout their intensive care unit stay for the development of an overt and/or clinically significant gastrointestinal (GI) bleed. More patients received a PPI (n=81) in contrast to a H2RA (n=19) for SUP. Overall, 94 patients (94%) had at least one risk factor for a SRMB with four patients (4%) experiencing an event (overt bleed, n=3; clinically significant bleed, n=1). All cases of GI bleeding occurred in patients receiving a PPI. No ICU deaths were considered directly related to a GI bleed.ConclusionsThe incidence of SRMB among high-risk critically ill oncology patients receiving SUP appears low; further, large-scale trials are needed to confirm this finding.

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