Interventions for preventing upper gastrointestinal bleeding in people admitted to intensive care units

Ingrid Toews; Aneesh Thomas George; John V Peter; Richard Kirubakaran; Luís Eduardo S Fontes; Jabez Paul Barnabas Ezekiel; Joerg J Meerpohl

doi:10.1002/14651858.CD008687.pub2

Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados
Respuestas clínicas Cochrane
Guías
Temas

Revisiones y protocolos relacionados

Respuestas clínicas Cochrane

Topics

Temas

Figure 1

PRISMA flow chart of included studies.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 4

Funnel plot of comparison: 1 Interventions versus placebo or no prophylaxis, outcome: 1.1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 5

Funnel plot of comparison: 2 H2 receptor antagonists versus placebo or no prophylaxis, outcome: 2.1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 6

Funnel plot of comparison: 9 H2 receptor antagonists versus proton pump inhibitors, outcome: 9.1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 7

Funnel plot of comparison: 10 H2 receptor antagonists versus antacids, outcome: 10.1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 8

Funnel plot of comparison: 11 H2 receptor antagonists versus sucralfate, outcome: 11.1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 9

Funnel plot of comparison: 19 Antacids versus sucralfate, outcome: 19.1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.1

Comparison 1 Interventions versus placebo or no prophylaxis, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.2

Comparison 1 Interventions versus placebo or no prophylaxis, Outcome 2 Nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.3

Comparison 1 Interventions versus placebo or no prophylaxis, Outcome 3 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.4

Comparison 1 Interventions versus placebo or no prophylaxis, Outcome 4 All‐cause mortality in hospital.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.5

Comparison 1 Interventions versus placebo or no prophylaxis, Outcome 5 Duration of ICU stay.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.6

Comparison 1 Interventions versus placebo or no prophylaxis, Outcome 6 Duration of intubation.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.7

Comparison 1 Interventions versus placebo or no prophylaxis, Outcome 7 Number of participants requiring blood transfusions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.8

Comparison 1 Interventions versus placebo or no prophylaxis, Outcome 8 Units of blood transfused.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.1

Comparison 2 H2 receptor antagonists versus placebo or no prophylaxis, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.2

Comparison 2 H2 receptor antagonists versus placebo or no prophylaxis, Outcome 2 Nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.3

Comparison 2 H2 receptor antagonists versus placebo or no prophylaxis, Outcome 3 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.4

Comparison 2 H2 receptor antagonists versus placebo or no prophylaxis, Outcome 4 All‐cause mortality in hospital.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.5

Comparison 2 H2 receptor antagonists versus placebo or no prophylaxis, Outcome 5 Duration of ICU stay.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.6

Comparison 2 H2 receptor antagonists versus placebo or no prophylaxis, Outcome 6 Duration of intubation.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.7

Comparison 2 H2 receptor antagonists versus placebo or no prophylaxis, Outcome 7 Number of participants requiring blood transfusions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.8

Comparison 2 H2 receptor antagonists versus placebo or no prophylaxis, Outcome 8 Units of blood transfused.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.9

Comparison 2 H2 receptor antagonists versus placebo or no prophylaxis, Outcome 9 Adverse events of interventions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.1

Comparison 3 Proton pump inhibitors versus placebo or no prophylaxis, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.2

Comparison 3 Proton pump inhibitors versus placebo or no prophylaxis, Outcome 2 Nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.3

Comparison 3 Proton pump inhibitors versus placebo or no prophylaxis, Outcome 3 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.4

Comparison 3 Proton pump inhibitors versus placebo or no prophylaxis, Outcome 4 All‐cause mortality in hospital.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.5

Comparison 3 Proton pump inhibitors versus placebo or no prophylaxis, Outcome 5 Duration of ICU stay.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.6

Comparison 3 Proton pump inhibitors versus placebo or no prophylaxis, Outcome 6 Duration of intubation.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.1

Comparison 4 Proton pump inhibitors + sucralfate versus no prophylaxis, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.1

Comparison 5 Prostaglandin analogues versus placebo or no prophylaxis, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.2

Comparison 5 Prostaglandin analogues versus placebo or no prophylaxis, Outcome 2 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.1

Comparison 6 Anticholinergics versus placebo or no prophylaxis, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.2

Comparison 6 Anticholinergics versus placebo or no prophylaxis, Outcome 2 Nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.3

Comparison 6 Anticholinergics versus placebo or no prophylaxis, Outcome 3 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 7.1

Comparison 7 Antacids versus placebo or no prophylaxis, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 7.2

Comparison 7 Antacids versus placebo or no prophylaxis, Outcome 2 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 7.3

Comparison 7 Antacids versus placebo or no prophylaxis, Outcome 3 All‐cause mortality in hospital.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 7.4

Comparison 7 Antacids versus placebo or no prophylaxis, Outcome 4 Number of participants requiring blood transfusions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 7.5

Comparison 7 Antacids versus placebo or no prophylaxis, Outcome 5 Adverse events of interventions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 8.1

Comparison 8 Sucralfate versus placebo or no prophylaxis, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 8.2

Comparison 8 Sucralfate versus placebo or no prophylaxis, Outcome 2 Nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 8.3

Comparison 8 Sucralfate versus placebo or no prophylaxis, Outcome 3 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 8.4

Comparison 8 Sucralfate versus placebo or no prophylaxis, Outcome 4 All‐cause mortality in hospital.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 8.5

Comparison 8 Sucralfate versus placebo or no prophylaxis, Outcome 5 Duration of ICU stay.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 8.6

Comparison 8 Sucralfate versus placebo or no prophylaxis, Outcome 6 Duration of intubation.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 8.7

Comparison 8 Sucralfate versus placebo or no prophylaxis, Outcome 7 Number of participants requiring blood transfusions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 8.8

Comparison 8 Sucralfate versus placebo or no prophylaxis, Outcome 8 Units of blood transfused.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 8.9

Comparison 8 Sucralfate versus placebo or no prophylaxis, Outcome 9 Adverse events of interventions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 9.1

Comparison 9 H2 receptor antagonists versus proton pump inhibitors, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 9.2

Comparison 9 H2 receptor antagonists versus proton pump inhibitors, Outcome 2 Nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 9.3

Comparison 9 H2 receptor antagonists versus proton pump inhibitors, Outcome 3 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 9.4

Comparison 9 H2 receptor antagonists versus proton pump inhibitors, Outcome 4 All‐cause mortality in hospital.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 9.5

Comparison 9 H2 receptor antagonists versus proton pump inhibitors, Outcome 5 Duration of ICU stay.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 9.6

Comparison 9 H2 receptor antagonists versus proton pump inhibitors, Outcome 6 Duration of intubation.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 9.7

Comparison 9 H2 receptor antagonists versus proton pump inhibitors, Outcome 7 Number of participants requiring blood transfusions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 9.8

Comparison 9 H2 receptor antagonists versus proton pump inhibitors, Outcome 8 Adverse events of interventions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 10.1

Comparison 10 H2 receptor antagonists versus antacids, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 10.2

Comparison 10 H2 receptor antagonists versus antacids, Outcome 2 Nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 10.3

Comparison 10 H2 receptor antagonists versus antacids, Outcome 3 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 10.4

Comparison 10 H2 receptor antagonists versus antacids, Outcome 4 All‐cause mortality in hospital.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 10.5

Comparison 10 H2 receptor antagonists versus antacids, Outcome 5 Duration of intubation.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 10.6

Comparison 10 H2 receptor antagonists versus antacids, Outcome 6 Number of participants requiring blood transfusions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 10.7

Comparison 10 H2 receptor antagonists versus antacids, Outcome 7 Adverse events of interventions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 11.1

Comparison 11 H2 receptor antagonists versus sucralfate, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 11.2

Comparison 11 H2 receptor antagonists versus sucralfate, Outcome 2 Nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 11.3

Comparison 11 H2 receptor antagonists versus sucralfate, Outcome 3 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 11.4

Comparison 11 H2 receptor antagonists versus sucralfate, Outcome 4 All‐cause mortality in hospital.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 11.5

Comparison 11 H2 receptor antagonists versus sucralfate, Outcome 5 Duration of intubation.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 11.6

Comparison 11 H2 receptor antagonists versus sucralfate, Outcome 6 Duration of ICU stay.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 11.7

Comparison 11 H2 receptor antagonists versus sucralfate, Outcome 7 Number of participants requiring blood transfusion.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 11.8

Comparison 11 H2 receptor antagonists versus sucralfate, Outcome 8 Units of blood transfused.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 11.9

Comparison 11 H2 receptor antagonists versus sucralfate, Outcome 9 Adverse events of interventions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 12.1

Comparison 12 H2 receptor antagonists versus anticholinergics, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 12.2

Comparison 12 H2 receptor antagonists versus anticholinergics, Outcome 2 Nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 12.3

Comparison 12 H2 receptor antagonists versus anticholinergics, Outcome 3 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 12.4

Comparison 12 H2 receptor antagonists versus anticholinergics, Outcome 4 Number of participants requiring blood transfusion.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 12.5

Comparison 12 H2 receptor antagonists versus anticholinergics, Outcome 5 Adverse events of interventions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 13.1

Comparison 13 H2 receptor antagonists versus prostaglandin analogues, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 13.2

Comparison 13 H2 receptor antagonists versus prostaglandin analogues, Outcome 2 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 14.1

Comparison 14 H2 receptor antagonists versus teprenone, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 14.2

Comparison 14 H2 receptor antagonists versus teprenone, Outcome 2 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 14.3

Comparison 14 H2 receptor antagonists versus teprenone, Outcome 3 Number of participants requiring blood transfusion.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 15.1

Comparison 15 H2 receptor antagonist + antacids versus sucralfate, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 15.2

Comparison 15 H2 receptor antagonist + antacids versus sucralfate, Outcome 2 Nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 15.3

Comparison 15 H2 receptor antagonist + antacids versus sucralfate, Outcome 3 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 15.4

Comparison 15 H2 receptor antagonist + antacids versus sucralfate, Outcome 4 Duration of ICU stay.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 15.5

Comparison 15 H2 receptor antagonist + antacids versus sucralfate, Outcome 5 Duration of intubation.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 15.6

Comparison 15 H2 receptor antagonist + antacids versus sucralfate, Outcome 6 Number of participants requiring blood transfusion.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 16.1

Comparison 16 Proton pump inhibitors versus teprenone, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 16.2

Comparison 16 Proton pump inhibitors versus teprenone, Outcome 2 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 16.3

Comparison 16 Proton pump inhibitors versus teprenone, Outcome 3 Number of participants requiring blood transfusion.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 17.1

Comparison 17 Proton pump inhibitor plus naloxone versus naloxone, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 17.2

Comparison 17 Proton pump inhibitor plus naloxone versus naloxone, Outcome 2 All‐cause mortality in hospital.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 17.3

Comparison 17 Proton pump inhibitor plus naloxone versus naloxone, Outcome 3 Adverse events ‐ gastrointestinal discomfort.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 18.1

Comparison 18 Proton pump inhibitors versus other medication (not defined), Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 18.2

Comparison 18 Proton pump inhibitors versus other medication (not defined), Outcome 2 Nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 18.3

Comparison 18 Proton pump inhibitors versus other medication (not defined), Outcome 3 All‐cause mortality in hospital.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 19.1

Comparison 19 Antacids versus sucralfate, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 19.2

Comparison 19 Antacids versus sucralfate, Outcome 2 Nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 19.3

Comparison 19 Antacids versus sucralfate, Outcome 3 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 19.4

Comparison 19 Antacids versus sucralfate, Outcome 4 All‐cause mortality in hospital.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 19.5

Comparison 19 Antacids versus sucralfate, Outcome 5 Duration of ICU stay.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 19.6

Comparison 19 Antacids versus sucralfate, Outcome 6 Duration of intubation.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 19.7

Comparison 19 Antacids versus sucralfate, Outcome 7 Number of participants requiring blood transfusion.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 19.8

Comparison 19 Antacids versus sucralfate, Outcome 8 Adverse events of interventions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 20.1

Comparison 20 Antacids versus prostaglandin analogues, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 20.2

Comparison 20 Antacids versus prostaglandin analogues, Outcome 2 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 20.3

Comparison 20 Antacids versus prostaglandin analogues, Outcome 3 Adverse events of interventions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 21.1

Comparison 21 Antacids versus bioflavonoids, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 21.2

Comparison 21 Antacids versus bioflavonoids, Outcome 2 Number of participants requiring blood transfusion.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 22.1

Comparison 22 Sucralfate versus proton pump inhibitors, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 22.2

Comparison 22 Sucralfate versus proton pump inhibitors, Outcome 2 Nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 22.3

Comparison 22 Sucralfate versus proton pump inhibitors, Outcome 3 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 22.4

Comparison 22 Sucralfate versus proton pump inhibitors, Outcome 4 All‐cause mortality in hospital.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 22.5

Comparison 22 Sucralfate versus proton pump inhibitors, Outcome 5 Duration of ICU stay.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 22.6

Comparison 22 Sucralfate versus proton pump inhibitors, Outcome 6 Duration of intubation.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 22.7

Comparison 22 Sucralfate versus proton pump inhibitors, Outcome 7 Number of participants requiring blood transfusion.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 22.8

Comparison 22 Sucralfate versus proton pump inhibitors, Outcome 8 Adverse events of interventions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 23.1

Comparison 23 Sucralfate versus bioflavonoids, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 23.2

Comparison 23 Sucralfate versus bioflavonoids, Outcome 2 Number of participants requiring blood transfusion.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 24.1

Comparison 24 Total parenteral nutrition (TPN) versus any other intervention + TPN, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 24.2

Comparison 24 Total parenteral nutrition (TPN) versus any other intervention + TPN, Outcome 2 All‐cause mortality in ICU.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 24.3

Comparison 24 Total parenteral nutrition (TPN) versus any other intervention + TPN, Outcome 3 Duration of intubation.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 25.1

Comparison 25 Bowel stimulation versus no prophylaxis, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 26.1

Comparison 26 Nasojejunal nutrition versus nasogastric nutrition, Outcome 1 Clinically important upper GI bleeding.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 26.2

Comparison 26 Nasojejunal nutrition versus nasogastric nutrition, Outcome 2 Nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 26.3

Comparison 26 Nasojejunal nutrition versus nasogastric nutrition, Outcome 3 All‐cause mortality in hospital.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 26.4

Comparison 26 Nasojejunal nutrition versus nasogastric nutrition, Outcome 4 Adverse events of interventions.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 27.1

Comparison 27 Enteral plus parenteral nutrition versus other nutrition regimens, Outcome 1 Nosocomial pneumonia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 27.2

Comparison 27 Enteral plus parenteral nutrition versus other nutrition regimens, Outcome 2 All‐cause mortality in hospital.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 27.3

Comparison 27 Enteral plus parenteral nutrition versus other nutrition regimens, Outcome 3 Duration of ICU stay.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 27.4

Comparison 27 Enteral plus parenteral nutrition versus other nutrition regimens, Outcome 4 Duration of intubation.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 27.5

Comparison 27 Enteral plus parenteral nutrition versus other nutrition regimens, Outcome 5 Adverse events ‐ stress ulcer.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 27.6

Comparison 27 Enteral plus parenteral nutrition versus other nutrition regimens, Outcome 6 Adverse events ‐ diarrhoea.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 27.7

Comparison 27 Enteral plus parenteral nutrition versus other nutrition regimens, Outcome 7 Adverse events ‐ pyaemia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 27.8

Comparison 27 Enteral plus parenteral nutrition versus other nutrition regimens, Outcome 8 Adverse events ‐ intracranial infection.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 27.9

Comparison 27 Enteral plus parenteral nutrition versus other nutrition regimens, Outcome 9 Adverse events ‐ hypoproteinaemia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Summary of findings for the main comparison. Interventions compared with placebo or no prophylaxis for preventing upper gastrointestinal bleeding in people admitted to intensive care units

Any intervention compared with placebo or no prophylaxis for preventing upper gastrointestinal bleeding in people admitted to intensive care units
Patient or population: people admitted to intensive care units Setting: ICU Intervention: any intervention Comparison: placebo or no prophylaxis
Outcomes	*Anticipated absolute effects (95% CI)**		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with placebo or no prophylaxis	Risk with Interventions
Clinically important upper GI bleeding Follow‐up: 15 days^†	Study population		RR 0.47 (0.39 to 0.57)	3207 (30 RCTs)	⊕⊕⊕⊝ MODERATE^a
	188 per 1000	88 per 1000 (73 to 107)
Nosocomial pneumonia Follow‐up: 48 hours after extubation^‡	Study population		RR 1.15 (0.90 to 1.48)	1331 (9 RCTs)	⊕⊕⊝⊝ LOW^b,c
	143 per 1000	164 per 1000 (129 to 211)
All‐cause mortality in ICU Follow‐up: 4 weeks^§	Study population		RR 1.10 (0.90 to 1.34)	2159 (19 RCTs)	⊕⊕⊝⊝ LOW^b,d
	152 per 1000	168 per 1000 (137 to 204)
Duration of ICU stay Follow‐up: not reported	Mean duration of ICU stay ranged from 8.6 to 11.1 days	MD 0.24 days higher (1.13 days lower to 1.61 higher days)	‐	447 (2 RCTs)	⊕⊕⊝⊝ LOW^b,e
Number of participants requiring blood transfusion Follow‐up: 48 hours after discharge^‡	Study population		RR 0.63 (0.41 to 0.97)	981 (9 RCTs)	⊕⊕⊕⊝ MODERATE^f
	96 per 1000	60 per 1000 (39 to 93)
Serious adverse events	Not reported
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). ^‡Duration of follow‐up reported in one study. ^†Duration of follow‐up reported in four studies. ^§Duration of follow‐up reported in five studies. CI: confidence interval; GI: gastrointestinal; ICU: intensive care unit; MD: mean difference; RCT: randomised controlled trial; RR: risk ratio.
GRADE Working Group grades of evidence. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.
^aDowngraded by one level for risk of bias because of high risk of selection bias in one study, high risk of performance bias in nine studies, high risk of detection bias in five studies, high risk of attrition bias in four studies, high risk of reporting bias in five studies, and high risk of other biases in four studies. ^bDowngraded by one level for imprecision because effect estimate and 95% CI were compatible with benefit and harm. ^cDowngraded by one level for risk of bias because of high risk of performance bias in three studies, high risk of detection bias in one study, and high risk of attrition bias in two studies. ^dDowngraded by one level for risk of bias because of high risk of performance bias in seven studies and high risk of attrition bias in two studies. ^eDowngraded by one level for risk of bias because of high risk of performance bias in one study. ^fDowngraded by one level for risk of bias because of high risk of selection bias in one study, high risk of performance bias in two studies, high risk of attrition bias in one study, high risk of reporting bias in one study, and high risk of other biases in one study.

Summary of findings for the main comparison. Interventions compared with placebo or no prophylaxis for preventing upper gastrointestinal bleeding in people admitted to intensive care units

Ir a la tabla de la revisión

Summary of findings 2. H2 receptor antagonists compared with placebo or no prophylaxis for preventing upper gastrointestinal bleeding in people admitted to intensive care units

H2 receptor antagonists compared with placebo or no prophylaxis for preventing upper gastrointestinal bleeding in people admitted to intensive care units
Patient or population: people admitted to intensive care units Setting: ICU Intervention: H2 receptor antagonists Comparison: placebo or no prophylaxis
Outcomes	*Anticipated absolute effects (95% CI)**		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with placebo or no prophylaxis	Risk with H2 receptor antagonists
Clinically important upper GI bleeding Follow‐up: 15 days/weeks^†	Study population		RR 0.50 (0.36 to 0.70)	2149 (24 RCTs)	⊕⊕⊕⊝ MODERATE^a
	182 per 1000	91 per 1000 (65 to 127)
Nosocomial pneumonia Follow‐up: 48 hours after extubation^‡	Study population		RR 1.12 (0.85 to 1.48)	945 (8 RCTs)	⊕⊕⊝⊝ LOW^b,c
	146 per 1000	164 per 1000 (124 to 216)
All‐cause mortality in ICU Follow‐up: 4 weeks^§	Study population		RR 1.12 (0.88 to 1.42)	1428 (14 RCTs)	⊕⊕⊝⊝ LOW^b,d
	145 per 1000	162 per 1000 (127 to 205)
Duration of ICU stay Follow‐up: not reported	Mean duration of ICU stay ranged from 8.6 to 11.1 days	MD 0.73 days higher (0.92 days lower to 2.38 days higher)	‐	230 (2 RCTs)	⊕⊕⊝⊝ LOW^b,e
Number of participants requiring blood transfusions Follow‐up: 48 hours after extubation^ǁ	Study population		RR 0.58 (0.36 to 0.95)	655 (7 RCTs)	⊕⊕⊕⊝ MODERATE^f
	112 per 1000	65 per 1000 (40 to 107)
Serious adverse events	Not reported
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). ^†Duration of follow‐up reported in four studies. ^‡Duration of follow‐up reported in two studies. ^§Duration of follow‐up reported in five studies. ^ǁDuration of follow‐up reported in one study. CI: confidence interval; GI: gastrointestinal; ICU: intensive care unit; MD: mean difference; RCT: randomised controlled trial; RR: risk ratio.
GRADE Working Group grades of evidence. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.
^aDowngraded by one level for risk of bias because of high risk of selection bias in one study, high risk of performance bias in eight studies, high risk of attrition bias in two studies, high risk of reporting bias in four studies, and high risk of other biases in three studies. ^bDowngraded by one level for imprecision because 95% CI was compatible with benefit and harm. ^cDowngraded by one level for risk of bias because of high risk performance bias in three studies and high risk of attrition bias in one study. ^dDowngraded by one level for risk of bias because of high risk of performance bias in three studies and high risk of attrition bias in one study. ^eDowngraded by one level for risk of bias because of high risk of performance bias in one study. ^fDowngraded by one level for risk of bias because of high risk of selection bias in one study, high risk of performance bias in two studies, high risk of attrition bias in one study, and high risk of other biases in one study.

Summary of findings 2. H2 receptor antagonists compared with placebo or no prophylaxis for preventing upper gastrointestinal bleeding in people admitted to intensive care units

Ir a la tabla de la revisión

Summary of findings 3. Proton pump inhibitors compared with placebo or no prophylaxis for preventing upper gastrointestinal bleeding in people admitted to intensive care units

Proton pump inhibitors compared with placebo or no prophylaxis for preventing upper gastrointestinal bleeding in people admitted to intensive care units
Patient or population: people admitted to intensive care units Setting: ICU Intervention: proton pump inhibitors Comparison: placebo or no prophylaxis
Outcomes	*Anticipated absolute effects (95% CI)**		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with placebo or no prophylaxis	Risk with proton pump inhibitors
Clinically important upper GI bleeding Follow‐up: not reported	Study population		RR 0.63 (0.18 to 2.22)	237 (3 RCTs)	⊕⊕⊝⊝ LOW^a,b
	49 per 1000	31 per 1000 (9 to 108)
Nosocomial pneumonia Follow‐up: not reported	Study population		RR 1.24 (0.77 to 1.98)	227 (2 RCTs)	⊕⊕⊝⊝ LOW^a,c
	188 per 1000	233 per 1000 (145 to 372)
All‐cause mortality in ICU Follow‐up: not reported	Study population		RR 1.09 (0.60 to 1.99)	258 (3 RCTs)	⊕⊕⊝⊝ LOW^a,c
	134 per 1000	146 per 1000 (80 to 266)
Duration of ICU stay Follow‐up: not reported	Mean duration of ICU stay ranged from 8.6 to 11.1 days	MD 0.03 days lower (1.63 days lower to 1.58 days higher)	‐	227 (2 RCTs)	⊕⊕⊝⊝ LOW^a,c
Number of participants requiring blood transfusion	Not reported
Serious adverse events	Not reported
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; GI: gastrointestinal; ICU: intensive care unit; MD: mean difference; RCT: randomised controlled trial; RR: risk ratio.
GRADE Working Group grades of evidence. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.
^aDowngraded by one level for imprecision because 95% CI was compatible with benefit and harm. ^bDowngraded by one level for risk of bias because of high risk of performance bias in one study and high risk of attrition bias in one study. ^cDowngraded by one level for risk of bias because of high risk of performance bias in one study.

Summary of findings 3. Proton pump inhibitors compared with placebo or no prophylaxis for preventing upper gastrointestinal bleeding in people admitted to intensive care units

Ir a la tabla de la revisión

Summary of findings 4. Antacids compared with placebo or no prophylaxis for preventing upper gastrointestinal bleeding in people admitted to intensive care units

Antacids compared with placebo or no prophylaxis for preventing upper gastrointestinal bleeding in people admitted to intensive care units
Patient or population: people admitted to intensive care units Setting: ICU Intervention: antacids Comparison: placebo or no prophylaxis
Outcomes	*Anticipated absolute effects (95% CI)**		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with placebo or no prophylaxis	Risk with antacids
Clinically important upper GI bleeding Follow‐up: not reported	Study population		RR 0.49 (0.25 to 0.99)	774 (8 RCTs)	⊕⊕⊝⊝ LOW^a,b
	170 per 1000	83 per 1000 (43 to 168)
Nosocomial pneumonia	Not reported
All‐cause mortality in ICU Follow‐up: not reported	Study population		RR 1.01 (0.53 to 1.96)	300 (2 RCTs)	⊕⊕⊝⊝ LOW^c,d
	161 per 1000	163 per 1000 (85 to 316)
Duration of ICU stay	Not reported
Number of participants requiring blood transfusions Follow‐up: not reported	Study population		RR 0.94 (0.30 to 2.96)	226 (2 RCTs)	⊕⊕⊝⊝ LOW^c,e
	45 per 1000	43 per 1000 (14 to 135)
Serious adverse events	Not reported
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; GI: gastrointestinal; ICU: intensive care unit; RCT: randomised controlled trial; RR: risk ratio.
GRADE Working Group grades of evidence. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.
^aDowngraded by one level for inconsistency because of moderate heterogeneity; I² = 56%. ^bDowngraded by one level for risk of bias because of high risk of performance bias in five studies, high risk of detection bias in one study, high risk of reporting bias in two studies, and high risk of other biases in one study. ^cDowngraded by one level for imprecision because 95% CI was compatible with benefit and harm. ^dDowngraded by one level for risk of bias because of high risk of performance bias in two studies. ^eDowngraded by one level for risk of bias because of high risk of performance bias in one study.

Summary of findings 4. Antacids compared with placebo or no prophylaxis for preventing upper gastrointestinal bleeding in people admitted to intensive care units

Ir a la tabla de la revisión

Summary of findings 5. Sucralfate compared with placebo or no prophylaxis for preventing upper gastrointestinal bleeding in people admitted to intensive care units

Sucralfate compared with placebo or no prophylaxis for preventing upper gastrointestinal bleeding in people admitted to intensive care units
Patient or population: people admitted to intensive care units Setting: ICU Intervention: sucralfate Comparison: placebo or no prophylaxis
Outcomes	*Anticipated absolute effects (95% CI)**		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with placebo or no prophylaxis	Risk with sucralfate
Clinically important upper GI bleeding Follow‐up: 15 days^†	Study population		RR 0.53 (0.32 to 0.88)	598 (7 RCTs)	⊕⊕⊕⊝ MODERATE^a
	108 per 1000	57 per 1000 (35 to 95)
Nosocomial pneumonia Follow‐up: not reported	Study population		RR 1.33 (0.86 to 2.04)	450 (4 RCTs)	⊕⊕⊝⊝ LOW^b,c
	122 per 1000	163 per 1000 (105 to 249)
All‐cause mortality in ICU Follow‐up: 15 days^†	Study population		RR 0.97 (0.66 to 1.43)	500 (5 RCTs)	⊕⊕⊝⊝ LOW^b,d
	165 per 1000	160 per 1000 (109 to 236)
Duration of ICU stay Follow‐up: not reported	Mean duration of ICU stay ranged from 8.6 to 11.1 days	MD 0.02 days lower (1.70 days lower to 1.65 days higher)	‐	224 (2 RCTs)	⊕⊕⊝⊝ LOW^b,e
Number of participants requiring blood transfusion Follow‐up: not reported	Study population		RR 0.60 (0.15 to 2.44)	200 (1 RCT)	⊕⊕⊝⊝ LOW^b,e
	50 per 1000	30 per 1000 (8 to 122)
Serious adverse events	Not reported
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). ^†Duration of follow‐up reported in only one study. CI: confidence interval; GI: gastrointestinal; ICU: intensive care unit; MD: mean difference; RCT: randomised controlled trial; RR: risk ratio.
GRADE Working Group grades of evidence. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.
^aDowngraded by one level for risk of bias because of high risk of performance bias in five studies, high risk of reporting bias in one study, and high risk of other biases in one study. ^bDowngraded by one level for imprecision because 95% CI was compatible with benefit and harm. ^cDowngraded by one level for risk of bias because of high risk of performance bias in two studies. ^dDowngraded by one level for risk of bias because of high risk of performance bias in three studies. ^eDowngraded by one level for risk of bias because of high risk of performance bias in one study.

Summary of findings 5. Sucralfate compared with placebo or no prophylaxis for preventing upper gastrointestinal bleeding in people admitted to intensive care units

Ir a la tabla de la revisión

Summary of findings 6. H2 receptor antagonists compared with proton pump inhibitors for preventing upper gastrointestinal bleeding in people admitted to intensive care units

H2 receptor antagonists compared with proton pump inhibitors for preventing upper gastrointestinal bleeding in people admitted to intensive care units
Patient or population: people admitted to intensive care units Setting: ICU Intervention: H2 receptor antagonists Comparison: proton pump inhibitors
Outcomes	*Anticipated absolute effects (95% CI)**		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with proton pump inhibitors	Risk with H2 receptor antagonists
Clinically important upper GI bleeding Follow‐up: not reported	Study population		RR 2.90 (1.83 to 4.58)	1636 (13 RCTs)	⊕⊕⊝⊝ LOW^a,b
	25 per 1000	73 per 1000 (46 to 115)
Nosocomial pneumonia Follow‐up: 30 days^†	Study population		RR 1.02 (0.77 to 1.35)	1256 (10 RCTs)	⊕⊕⊝⊝ LOW^c,d
	123 per 1000	126 per 1000 (95 to 166)
All‐cause mortality in ICU Follow‐up: 30 days^†	Study population		RR 0.96 (0.78 to 1.19)	1564 (12 RCTs)	⊕⊕⊝⊝ LOW^c,e
	158 per 1000	152 per 1000 (124 to 189)
Duration of ICU stay Follow‐up: not reported	Mean duration of ICU stay ranged from 7.7 to 23.6 days	MD 0.14 days higher (1.14 days lower to 1.41 days higher)	‐	482 (5 RCTs)	⊕⊕⊝⊝ LOW^c,f
Number of participants requiring blood transfusion Follow‐up: not reported	Study population		RR 1.98 (0.75 to 5.21)	575 (3 RCTs)	⊕⊕⊕⊝ MODERATE^c
	17 per 1000	35 per 1000 (13 to 91)
Serious adverse events	Not reported
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). ^†Duration of follow‐up reported in only one study. CI: confidence interval; GI: gastrointestinal; ICU: intensive care unit; MD: mean difference; RCT: randomised controlled trial; RR: risk ratio.
GRADE Working Group grades of evidence. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.
^aDowngraded by one level for inconsistency because of substantial heterogeneity; I² = 59%. ^bDowngraded by one level for risk of bias because of high risk of selection bias in one study, high risk of performance bias in five studies, high risk of detection bias in two studies, and high risk of other biases in one study. ^cDowngraded by one level for imprecision because 95% CI was compatible with benefit and harm. ^dDowngraded by one level for risk of bias because of high risk of performance bias in four studies, high risk of detection bias in two studies, and high risk of other biases in one study. ^eDowngraded by one level for risk of bias because of high risk of performance bias in five studies, high risk of attrition bias in one study, and high risk of other biases in one study. ^fDowngraded by one level for risk of bias because of high risk of performance bias in three studies, high risk of attrition bias in one study, and high risk of other biases in one study.

Summary of findings 6. H2 receptor antagonists compared with proton pump inhibitors for preventing upper gastrointestinal bleeding in people admitted to intensive care units

Ir a la tabla de la revisión

Summary of findings 7. H2 receptor antagonists compared with antacids for preventing upper gastrointestinal bleeding in people admitted to intensive care units

H2 receptor antagonists compared with antacids for preventing upper gastrointestinal bleeding in people admitted to intensive care units
Patient or population: people admitted to intensive care units Setting: ICU Intervention: H2 receptor antagonists Comparison: antacids
Outcomes	*Anticipated absolute effects (95% CI)**		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with antacids	Risk with H2 receptor antagonists
Clinically important upper GI bleeding Follow‐up: 25 days^†	Study population		RR 0.96 (0.67 to 1.36)	1700 (16 RCTs)	⊕⊕⊝⊝ LOW^a,b
	86 per 1000	82 per 1000 (57 to 117)
Nosocomial pneumonia Follow‐up: 25 days^‡	Study population		RR 1.05 (0.81 to 1.36)	581 (4 RCTs)	⊕⊕⊝⊝ LOW^a,c
	280 per 1000	294 per 1000 (227 to 381)
All‐cause mortality in ICU Follow‐up: 25 days^§	Study population		RR 1.01 (0.66 to 1.55)	1321 (11 RCTs)	⊕⊝⊝⊝ VERY LOW^a,d,e
	163 per 1000	165 per 1000 (108 to 253)
Duration of ICU stay	Not reported
Number of participants requiring blood transfusion Follow‐up: not reported	Study population		RR 2.49 (1.35 to 4.62)	744 (6 RCTs)	⊕⊕⊕⊝ MODERATE^f
	30 per 1000	75 per 1000 (41 to 139)
Serious adverse events	Not reported
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). ^†Duration of follow‐up reported in two studies. ^‡Duration of follow‐up reported in one study. ^§Duration of follow‐up reported in three studies. CI: confidence interval; GI: gastrointestinal; ICU: intensive care unit; RCT: randomised controlled trial; RR: risk ratio.
GRADE Working Group grades of evidence. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.
^aDowngraded by one level for imprecision because 95% CI was compatible with benefit and harm. ^bDowngraded by one level for risk of bias because of high risk of selection bias in two studies, high risk of performance bias in 12 studies, high risk of detection bias in two studies, and high risk of reporting bias in two studies. ^cDowngraded by one level for risk of bias because of high risk of selection bias in one study, high risk of performance bias in four studies, high risk of detection bias in one study, and high risk of reporting bias in one study. ^dDowngraded by one level for inconsistency because of moderate heterogeneity; I² = 53%. ^eDowngraded by one level for risk of bias because of high risk of selection bias in two studies, high risk of performance bias in nine studies, and high risk of reporting bias in one study. ^fDowngraded by one level for risk of bias because of high risk of selection bias in one study and high risk of performance bias in four studies.

Summary of findings 7. H2 receptor antagonists compared with antacids for preventing upper gastrointestinal bleeding in people admitted to intensive care units

Ir a la tabla de la revisión

Summary of findings 8. H2 receptor antagonists compared with sucralfate for preventing upper gastrointestinal bleeding in people admitted to intensive care units

H2 receptor antagonists compared with sucralfate for preventing upper gastrointestinal bleeding in people admitted to intensive care units
Patient or population: people admitted to intensive care units Setting: ICU Intervention: H2 receptor antagonists Comparison: sucralfate
Outcomes	*Anticipated absolute effects (95% CI)**		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with sucralfate	Risk with H2 receptor antagonists
Clinically important upper GI bleeding Follow‐up: 15 days^†	Study population		RR 1.10 (0.87 to 1.41)	3316 (24 RCTs)	⊕⊕⊝⊝ LOW^a,b
	66 per 1000	73 per 1000 (58 to 93)
Nosocomial pneumonia Follow‐up: 25 days^‡	Study population		RR 1.22 (1.07 to 1.40)	3041 (17 RCTs)	⊕⊕⊕⊝ MODERATE^c
	189 per 1000	230 per 1000 (202 to 264)
All‐cause mortality in ICU Follow‐up: 25 days^§	Study population		RR 1.09 (0.95 to 1.24)	3178 (21 RCTs)	⊕⊕⊝⊝ LOW^a,d
	204 per 1000	222 per 1000 (194 to 253)
Duration of ICU stay Follow‐up: 2 weeks	Mean duration of ICU stay ranged from 7.9 to 13.7 days	MD 0.01 days higher (1.92 days lower to 1.95 days higher)	‐	1791 (6 RCTs)	⊕⊝⊝⊝ VERY LOW^a,e,f
Number of participants requiring blood transfusion Follow‐up: until death or discharge^ǁ	Study population		RR 1.25 (0.70 to 2.23)	1095 (9 RCTs)	⊕⊕⊝⊝ LOW^a,g
	35 per 1000	43 per 1000 (24 to 77)
Serious adverse events	Not reported
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). ^†Duration of follow‐up reported in five studies. ^‡Duration of follow‐up reported in three studies. ^§Duration of follow‐up reported in six studies. ^ǁDuration of follow‐up reported in one study. CI: confidence interval; GI: gastrointestinal; ICU: intensive care unit; MD: mean difference; RCT: randomised controlled trial; RR: risk ratio.
GRADE Working Group grades of evidence. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.
^aDowngraded by one level for imprecision because 95% CI was compatible with benefit and harm. ^bDowngraded by one level for risk of bias because of high risk of selection bias in one study, high risk of performance bias in 20 studies, high risk of detection bias in two studies, high risk of attrition bias in two studies, high risk of reporting bias in four studies, and high risk of other biases in two studies. ^cDowngraded by one level for risk of bias because of high risk of selection bias in two studies, high risk of performance bias in 12 studies, high risk of detection bias in one study, high risk of attrition bias in one study, and high risk of reporting bias in two studies. ^dDowngraded by one level for risk of bias because of high risk of selection bias in two studies, high risk of performance bias in 16 studies, high risk of detection bias in one study, high risk of attrition bias in two studies, high risk of reporting bias in three studies, and high risk of other biases in one study. ^eDowngraded by one level for inconsistency because of considerable heterogeneity; I² = 82%. ^fDowngraded by one level for risk of bias because of high risk of performance bias in four studies and high risk of attrition bias in one study. ^gDowngraded by one level for risk of bias because of high risk of performance bias in eight studies, high risk of attrition bias in one study, high risk of reporting bias in one study, and high risk of other biases in one study.

Summary of findings 8. H2 receptor antagonists compared with sucralfate for preventing upper gastrointestinal bleeding in people admitted to intensive care units

Ir a la tabla de la revisión

Summary of findings 9. Antacids compared with sucralfate for preventing upper gastrointestinal bleeding in people admitted to intensive care units

Antacids compared with sucralfate for preventing upper gastrointestinal bleeding in people admitted to intensive care units
Patient or population: people admitted to intensive care units Setting: ICU Intervention: antacids Comparison: sucralfate
Outcomes	*Anticipated absolute effects (95% CI)**		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with sucralfate	Risk with antacids
Clinically important upper GI bleeding Follow‐up: 21 days^†	Study population		RR 1.00 (0.72 to 1.39)	1772 (16 RCTs)	⊕⊕⊝⊝ LOW^a,b
	66 per 1000	66 per 1000 (47 to 91)
Nosocomial pneumonia Follow‐up: 25 days^‡	Study population		RR 1.04 (0.84 to 1.30)	996 (7 RCTs)	⊕⊕⊝⊝ LOW^a,c
	232 per 1000	242 per 1000 (195 to 302)
All‐cause mortality in ICU Follow‐up: 25 days^†	Study population		RR 1.15 (0.93 to 1.40)	1249 (11 RCTs)	⊕⊕⊝⊝ LOW^a,d
	206 per 1000	237 per 1000 (192 to 289)
Duration of ICU stay Follow‐up: not reported	Mean duration of ICU stay ranged from 10.4 to 16.8 days	MD 2.5 days lower (6.61 days lower to 1.61 days higher)	‐	227 (2 RCTs)	⊕⊕⊝⊝ LOW^a,e
Number of participants requiring blood transfusion Follow‐up: until discharge or onset of GI bleeding^§	Study population		RR 0.73 (0.40 to 1.34)	667 (6 RCTs)	⊕⊕⊝⊝ LOW^a,f
	52 per 1000	38 per 1000 (21 to 69)
Serious adverse events	Not reported
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). ^†Duration of follow‐up reported in four studies. ^‡Duration of follow‐up reported in two studies. ^§Duration of follow‐up reported in one study. CI: confidence interval; GI: gastrointestinal; ICU: intensive care unit; MD: mean difference; RCT: randomised controlled trial; RR: risk ratio.
GRADE Working Group grades of evidence. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.
^aDowngraded by one level for imprecision because 95% CI was compatible with benefit and harm. ^bDowngraded by one level for risk of bias because of high risk of selection bias in three studies, high risk of performance bias in 12 studies, high risk of detection bias in one study, high risk of attrition bias in one study, high risk of reporting bias in two studies, and high risk of other biases in two studies. ^cDowngraded by one level for risk of bias because of high risk of performance bias in four studies, high risk of detection bias in one study, high risk of reporting bias in one study, and high risk of other biases in one study. ^dDowngraded by one level for risk of bias because of high risk of selection bias in three studies, high risk of performance bias in eight studies, high risk of attrition bias in one study, high risk of reporting bias in one study, and high risk of other biases in one study. ^eDowngraded by one level for risk of bias because of high risk of attrition bias in one study. ^fDowngraded by one level for risk of bias because of high risk of selection bias in one study, high risk of performance bias in six studies, and high risk of other biases in one study.

Summary of findings 9. Antacids compared with sucralfate for preventing upper gastrointestinal bleeding in people admitted to intensive care units

Ir a la tabla de la revisión

Comparison 1. Interventions versus placebo or no prophylaxis

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	30	3132	Risk Ratio (M‐H, Fixed, 95% CI)	0.47 [0.39, 0.57]

1.1 H2 receptor antagonists vs placebo or no prophylaxis	24	1844	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.37, 0.59]
1.2 Proton pump inhibitors vs placebo or no prophylaxis	3	159	Risk Ratio (M‐H, Fixed, 95% CI)	0.57 [0.13, 2.59]
1.3 Prostagladin analogues vs placebo or no prophylaxis	1	58	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.22, 4.55]
1.4 Anticholinergics vs placebo or no prophylaxis	2	103	Risk Ratio (M‐H, Fixed, 95% CI)	0.87 [0.30, 2.49]
1.5 Antacids vs placebo or no prophylaxis	7	515	Risk Ratio (M‐H, Fixed, 95% CI)	0.39 [0.23, 0.63]
1.6 Sucralfate vs placebo or no prophylaxis	7	453	Risk Ratio (M‐H, Fixed, 95% CI)	0.47 [0.25, 0.87]
2 Nosocomial pneumonia Show forest plot	9	1331	Risk Ratio (M‐H, Fixed, 95% CI)	1.15 [0.90, 1.48]

2.1 H2 receptor antagonists vs placebo or no prophylaxis	8	788	Risk Ratio (M‐H, Fixed, 95% CI)	1.06 [0.77, 1.46]
2.2 Proton pump inhibitors vs placebo or no prophylaxis	2	149	Risk Ratio (M‐H, Fixed, 95% CI)	1.13 [0.59, 2.17]
2.3 Anticholinergics vs placebo or no prophylaxis	1	72	Risk Ratio (M‐H, Fixed, 95% CI)	1.06 [0.43, 2.59]
2.4 Sucralfate vs placebo or no prophylaxis	4	322	Risk Ratio (M‐H, Fixed, 95% CI)	1.59 [0.84, 3.01]
3 All‐cause mortality in ICU Show forest plot	19	2159	Risk Ratio (M‐H, Fixed, 95% CI)	1.10 [0.90, 1.34]

3.1 H2 receptor antagonists vs placebo or no prophylaxis	14	1209	Risk Ratio (M‐H, Fixed, 95% CI)	1.16 [0.89, 1.53]
3.2 Proton pump inhibitors vs placebo or no prophylaxis	3	180	Risk Ratio (M‐H, Fixed, 95% CI)	1.05 [0.46, 2.38]
3.3 Prostagladin analogues vs placebo or no prophylaxis	1	58	Risk Ratio (M‐H, Fixed, 95% CI)	1.14 [0.48, 2.74]
3.4 Anticholinergics vs placebo or no prophylaxis	2	103	Risk Ratio (M‐H, Fixed, 95% CI)	1.22 [0.59, 2.56]
3.5 Antacids vs placebo or no prophylaxis	2	250	Risk Ratio (M‐H, Fixed, 95% CI)	1.02 [0.58, 1.79]
3.6 Sucralfate vs placebo or no prophylaxis	5	359	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.58, 1.51]
4 All‐cause mortality in hospital Show forest plot	5	857	Risk Ratio (M‐H, Fixed, 95% CI)	1.15 [0.85, 1.55]

4.1 H2 receptor antagonists vs placebo or no prophylaxis	4	387	Risk Ratio (M‐H, Fixed, 95% CI)	1.14 [0.71, 1.83]
4.2 Proton pump inhibitors vs placebo or no prophylaxis	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	1.17 [0.42, 3.22]
4.3 Antacids vs placebo or no prophylaxis	1	126	Risk Ratio (M‐H, Fixed, 95% CI)	1.44 [0.79, 2.64]
4.4 Sucralfate vs placebo or no prophylaxis	2	244	Risk Ratio (M‐H, Fixed, 95% CI)	0.94 [0.53, 1.68]
5 Duration of ICU stay Show forest plot	2	447	Mean Difference (IV, Fixed, 95% CI)	0.24 [‐1.13, 1.61]

5.1 H2 receptor antagonists vs placebo or no prophylaxis	2	152	Mean Difference (IV, Fixed, 95% CI)	0.73 [‐1.64, 3.09]
5.2 Proton pump inhibitors vs placebo or no prophylaxis	2	149	Mean Difference (IV, Fixed, 95% CI)	0.01 [‐2.33, 2.35]
5.3 Sucralfate vs placebo or no prophylaxis	2	146	Mean Difference (IV, Fixed, 95% CI)	‐0.01 [‐2.40, 2.38]
6 Duration of intubation Show forest plot	2	447	Mean Difference (IV, Fixed, 95% CI)	0.87 [‐0.58, 2.31]

6.1 H2 receptor antagonists vs placebo or no prophylaxis	2	152	Mean Difference (IV, Fixed, 95% CI)	0.78 [‐1.72, 3.29]
6.2 Proton pump inhibitors vs placebo or no prophylaxis	2	149	Mean Difference (IV, Fixed, 95% CI)	0.36 [‐2.18, 2.90]
6.3 Sucralfate vs placebo or no prophylaxis	2	146	Mean Difference (IV, Fixed, 95% CI)	1.43 [‐1.04, 3.89]
7 Number of participants requiring blood transfusions Show forest plot	9	981	Risk Ratio (M‐H, Fixed, 95% CI)	0.63 [0.41, 0.97]

7.1 H2 receptor antagonists vs placebo or no prophylaxis	7	605	Risk Ratio (M‐H, Fixed, 95% CI)	0.57 [0.35, 0.94]
7.2 Antacids vs placebo or no prophylaxis	2	226	Risk Ratio (M‐H, Fixed, 95% CI)	0.94 [0.30, 2.96]
7.3 Sucralfate vs placebo or no prophylaxis	1	150	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.13, 4.34]
8 Units of blood transfused Show forest plot	2	309	Mean Difference (IV, Random, 95% CI)	0.09 [‐0.99, 1.17]

8.1 H2 receptor antagonists vs placebo or no prophylaxis	2	159	Mean Difference (IV, Random, 95% CI)	‐1.73 [‐6.37, 2.90]
8.2 Sucralfate vs placebo or no prophylaxis	1	150	Mean Difference (IV, Random, 95% CI)	0.80 [0.25, 1.35]

Comparison 1. Interventions versus placebo or no prophylaxis

Ir a la tabla de la revisión

Comparison 2. H2 receptor antagonists versus placebo or no prophylaxis

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	24	2149	Risk Ratio (M‐H, Random, 95% CI)	0.50 [0.36, 0.70]

1.1 Cimetidine vs placebo	10	772	Risk Ratio (M‐H, Random, 95% CI)	0.53 [0.28, 1.02]
1.2 Famotidine vs placebo	1	146	Risk Ratio (M‐H, Random, 95% CI)	2.11 [0.20, 22.79]
1.3 Ranitidine vs placebo	5	446	Risk Ratio (M‐H, Random, 95% CI)	0.36 [0.17, 0.77]
1.4 Cimetidine vs no prophylaxis	3	516	Risk Ratio (M‐H, Random, 95% CI)	0.59 [0.23, 1.48]
1.5 Famotidine vs no prophylaxis	1	50	Risk Ratio (M‐H, Random, 95% CI)	0.3 [0.09, 0.96]
1.6 Ranitidine vs no prophylaxis	4	219	Risk Ratio (M‐H, Random, 95% CI)	0.51 [0.26, 1.00]
2 Nosocomial pneumonia Show forest plot	8	945	Risk Ratio (M‐H, Fixed, 95% CI)	1.12 [0.85, 1.48]

2.1 Cimetidine vs placebo	2	204	Risk Ratio (M‐H, Fixed, 95% CI)	0.34 [0.06, 2.00]
2.2 Famotidine vs placebo	1	146	Risk Ratio (M‐H, Fixed, 95% CI)	1.48 [0.49, 4.45]
2.3 Ranitidine vs placebo	2	277	Risk Ratio (M‐H, Fixed, 95% CI)	0.79 [0.47, 1.31]
2.4 Cimetidine vs no prophylaxis	1	200	Risk Ratio (M‐H, Fixed, 95% CI)	2.17 [0.86, 5.47]
2.5 Ranitidine vs no prophylaxis	2	118	Risk Ratio (M‐H, Fixed, 95% CI)	1.33 [0.93, 1.90]
3 All‐cause mortality in ICU Show forest plot	14	1428	Risk Ratio (M‐H, Fixed, 95% CI)	1.12 [0.88, 1.42]

3.1 Cimetidine vs placebo	4	478	Risk Ratio (M‐H, Fixed, 95% CI)	1.05 [0.66, 1.68]
3.2 Famotidine vs placebo	1	146	Risk Ratio (M‐H, Fixed, 95% CI)	1.32 [0.55, 3.16]
3.3 Ranitidine vs placebo	2	148	Risk Ratio (M‐H, Fixed, 95% CI)	0.69 [0.31, 1.54]
3.4 Cimetidine vs no prophylaxis	2	400	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.61, 1.63]
3.5 Famotidine vs no prophylaxis	1	50	Risk Ratio (M‐H, Fixed, 95% CI)	1.25 [0.59, 2.64]
3.6 Ranitidine vs no prophylaxis	4	206	Risk Ratio (M‐H, Fixed, 95% CI)	1.58 [0.97, 2.58]
4 All‐cause mortality in hospital Show forest plot	4	487	Risk Ratio (M‐H, Fixed, 95% CI)	1.16 [0.79, 1.70]

4.1 Famotidine vs placebo	1	146	Risk Ratio (M‐H, Fixed, 95% CI)	0.89 [0.43, 1.86]
4.2 Ranitidine vs placebo	1	101	Risk Ratio (M‐H, Fixed, 95% CI)	0.35 [0.01, 8.47]
4.3 Cimetidine vs no prophylaxis	1	200	Risk Ratio (M‐H, Fixed, 95% CI)	1.47 [0.88, 2.46]
4.4 Ranitidine vs no prophylaxis	1	40	Risk Ratio (M‐H, Fixed, 95% CI)	0.92 [0.33, 2.53]
5 Duration of ICU stay Show forest plot	2	230	Mean Difference (IV, Fixed, 95% CI)	0.73 [‐0.92, 2.38]

5.1 Famotidine vs placebo	1	146	Mean Difference (IV, Fixed, 95% CI)	1.5 [‐1.93, 4.93]
5.2 Ranitidine vs no prophylaxis	1	84	Mean Difference (IV, Fixed, 95% CI)	0.5 [‐1.38, 2.38]
6 Duration of intubation Show forest plot	2	230	Mean Difference (IV, Fixed, 95% CI)	0.79 [‐0.95, 2.54]

6.1 Famotidine vs placebo	1	146	Mean Difference (IV, Fixed, 95% CI)	1.20 [‐1.86, 4.26]
6.2 Ranitidine vs no prophylaxis	1	84	Mean Difference (IV, Fixed, 95% CI)	0.60 [‐1.52, 2.72]
7 Number of participants requiring blood transfusions Show forest plot	7	655	Risk Ratio (M‐H, Fixed, 95% CI)	0.58 [0.36, 0.95]

7.1 Cimetidine vs placebo	3	107	Risk Ratio (M‐H, Fixed, 95% CI)	0.39 [0.19, 0.79]
7.2 Ranitidine vs placebo	2	148	Risk Ratio (M‐H, Fixed, 95% CI)	1.05 [0.24, 4.60]
7.3 Cimetidine vs no prophylaxis	2	400	Risk Ratio (M‐H, Fixed, 95% CI)	0.77 [0.35, 1.71]
8 Units of blood transfused Show forest plot	2	209	Mean Difference (IV, Fixed, 95% CI)	0.33 [‐0.04, 0.70]

8.1 Cimetidine vs placebo	1	9	Mean Difference (IV, Fixed, 95% CI)	‐4.35 [‐7.35, ‐1.35]
8.2 Cimetidine vs no prophylaxis	1	200	Mean Difference (IV, Fixed, 95% CI)	0.40 [0.03, 0.77]
9 Adverse events of interventions Show forest plot	8		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

9.1 Diarrhoea	2	225	Risk Ratio (M‐H, Fixed, 95% CI)	1.30 [0.57, 2.96]
9.2 Thrombocytopenia	1	200	Risk Ratio (M‐H, Fixed, 95% CI)	3.0 [0.12, 72.77]
9.3 Hypophosphatemia	1	25	Risk Ratio (M‐H, Fixed, 95% CI)	3.75 [0.17, 84.02]
9.4 Mental confusion	5	657	Risk Ratio (M‐H, Fixed, 95% CI)	2.01 [1.10, 3.65]
9.5 Nausea and vomiting	2	287	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.09, 2.35]
9.6 Increased creatinine levels	1	200	Risk Ratio (M‐H, Fixed, 95% CI)	1.04 [0.64, 1.69]
9.7 Erythema	1	70	Risk Ratio (M‐H, Fixed, 95% CI)	3.0 [0.13, 71.22]
9.8 Pancreatitis	1	39	Risk Ratio (M‐H, Fixed, 95% CI)	0.29 [0.01, 6.66]
9.9 Chest infection	1	101	Risk Ratio (M‐H, Fixed, 95% CI)	1.74 [0.92, 3.30]
9.10 Delirium	1	39	Risk Ratio (M‐H, Fixed, 95% CI)	2.59 [0.11, 59.93]
9.11 Hallucinations	1	39	Risk Ratio (M‐H, Fixed, 95% CI)	2.59 [0.11, 59.93]
9.12 Severe bleeding	1	101	Risk Ratio (M‐H, Fixed, 95% CI)	0.35 [0.01, 8.47]

Comparison 2. H2 receptor antagonists versus placebo or no prophylaxis

Ir a la tabla de la revisión

Comparison 3. Proton pump inhibitors versus placebo or no prophylaxis

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	3	237	Risk Ratio (M‐H, Fixed, 95% CI)	0.63 [0.18, 2.22]

1.1 Omeprazole vs placebo	1	147	Risk Ratio (M‐H, Fixed, 95% CI)	1.04 [0.07, 16.34]
1.2 Omeprazole vs no prophylaxis	1	80	Risk Ratio (M‐H, Fixed, 95% CI)	0.74 [0.13, 4.18]
1.3 Pantoprazole vs placebo	1	10	Risk Ratio (M‐H, Fixed, 95% CI)	0.28 [0.02, 4.66]
2 Nosocomial pneumonia Show forest plot	2	227	Risk Ratio (M‐H, Fixed, 95% CI)	1.24 [0.77, 1.98]

2.1 Omeprazole vs placebo	1	147	Risk Ratio (M‐H, Fixed, 95% CI)	1.67 [0.57, 4.86]
2.2 Omeprazole vs no prophylaxis	1	80	Risk Ratio (M‐H, Fixed, 95% CI)	1.11 [0.66, 1.84]
3 All‐cause mortality in ICU Show forest plot	3	258	Risk Ratio (M‐H, Fixed, 95% CI)	1.09 [0.60, 1.99]

3.1 Omeprazole vs placebo	2	178	Risk Ratio (M‐H, Fixed, 95% CI)	1.20 [0.51, 2.83]
3.2 Omeprazole vs no prophylaxis	1	80	Risk Ratio (M‐H, Fixed, 95% CI)	0.98 [0.42, 2.29]
4 All‐cause mortality in hospital Show forest plot	1	150	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.54, 2.13]

4.1 Omeprazole vs placebo	1	150	Risk Ratio (M‐H, Fixed, 95% CI)	1.08 [0.54, 2.13]
5 Duration of ICU stay Show forest plot	2	227	Mean Difference (IV, Fixed, 95% CI)	‐0.03 [‐1.63, 1.58]

5.1 Omeprazole vs placebo	1	147	Mean Difference (IV, Fixed, 95% CI)	‐0.90 [‐3.96, 2.16]
5.2 Omeprazole vs no prophylaxis	1	80	Mean Difference (IV, Fixed, 95% CI)	0.30 [‐1.58, 2.18]
6 Duration of intubation Show forest plot	2	227	Mean Difference (IV, Fixed, 95% CI)	0.36 [‐1.43, 2.15]

6.1 Omeprazole vs placebo	1	147	Mean Difference (IV, Fixed, 95% CI)	0.5 [‐2.72, 3.72]
6.2 Omeprazole vs no prophylaxis	1	80	Mean Difference (IV, Fixed, 95% CI)	0.30 [‐1.85, 2.45]

Comparison 3. Proton pump inhibitors versus placebo or no prophylaxis

Ir a la tabla de la revisión

Comparison 4. Proton pump inhibitors + sucralfate versus no prophylaxis

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 4. Proton pump inhibitors + sucralfate versus no prophylaxis

Ir a la tabla de la revisión

Comparison 5. Prostaglandin analogues versus placebo or no prophylaxis

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

1.1 Prostaglandin analogues vs placebo	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 All‐cause mortality in ICU Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 5. Prostaglandin analogues versus placebo or no prophylaxis

Ir a la tabla de la revisión

Comparison 6. Anticholinergics versus placebo or no prophylaxis

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	2	131	Risk Ratio (M‐H, Fixed, 95% CI)	0.95 [0.36, 2.51]

1.1 Pirenzepine vs placebo	1	101	Risk Ratio (M‐H, Fixed, 95% CI)	1.94 [0.34, 11.13]
1.2 Pirenzepin + ranitidine vs placebo + ranitidine	1	30	Risk Ratio (M‐H, Fixed, 95% CI)	0.6 [0.17, 2.07]
2 Nosocomial pneumonia Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2.1 Pirenzepine vs placebo	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 All‐cause mortality in ICU Show forest plot	2	131	Risk Ratio (M‐H, Fixed, 95% CI)	1.23 [0.66, 2.30]

3.1 Pirenzepine vs placebo	1	101	Risk Ratio (M‐H, Fixed, 95% CI)	1.30 [0.65, 2.60]
3.2 Pirenzepine + ranitidine vs placebo + ranitidine	1	30	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.24, 4.18]

Comparison 6. Anticholinergics versus placebo or no prophylaxis

Ir a la tabla de la revisión

Comparison 7. Antacids versus placebo or no prophylaxis

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	8	774	Risk Ratio (M‐H, Random, 95% CI)	0.49 [0.25, 0.99]

1.1 Antacids vs placebo	2	145	Risk Ratio (M‐H, Random, 95% CI)	2.04 [0.72, 5.79]
1.2 Antacids vs no prophylaxis	6	629	Risk Ratio (M‐H, Random, 95% CI)	0.35 [0.20, 0.60]
2 All‐cause mortality in ICU Show forest plot	2	300	Risk Ratio (M‐H, Random, 95% CI)	1.01 [0.53, 1.96]

2.1 Antacids vs no prophylaxis	2	300	Risk Ratio (M‐H, Random, 95% CI)	1.01 [0.53, 1.96]
3 All‐cause mortality in hospital Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3.1 Antacids vs no prophylaxis	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Number of participants requiring blood transfusions Show forest plot	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

4.1 Antacids vs no prophylaxis	2	226	Risk Ratio (M‐H, Fixed, 95% CI)	0.94 [0.30, 2.96]
5 Adverse events of interventions Show forest plot	4		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

5.1 Diarrhoea	4	395	Risk Ratio (M‐H, Fixed, 95% CI)	3.56 [1.83, 6.94]
5.2 Hypomagnesaemia	1	25	Risk Ratio (M‐H, Fixed, 95% CI)	3.75 [0.17, 84.02]
5.3 Hypophosphataemia	2	225	Risk Ratio (M‐H, Fixed, 95% CI)	5.48 [1.81, 16.61]
5.4 Hypermagnesaemia	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	6.73 [0.36, 127.02]
5.5 Nausea and vomiting	3	370	Risk Ratio (M‐H, Fixed, 95% CI)	2.39 [0.86, 6.64]
5.6 Mental confusion	1	200	Risk Ratio (M‐H, Fixed, 95% CI)	1.27 [0.61, 2.67]
5.7 Creatinine increase	1	200	Risk Ratio (M‐H, Fixed, 95% CI)	1.17 [0.73, 1.87]

Comparison 7. Antacids versus placebo or no prophylaxis

Ir a la tabla de la revisión

Comparison 8. Sucralfate versus placebo or no prophylaxis

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	7	598	Risk Ratio (M‐H, Fixed, 95% CI)	0.53 [0.32, 0.88]

1.1 Sucralfate vs placebo	2	170	Risk Ratio (M‐H, Fixed, 95% CI)	1.40 [0.30, 6.62]
1.2 Sucralfate vs no prophylaxis	5	428	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.26, 0.80]
2 Nosocomial pneumonia Show forest plot	4	450	Risk Ratio (M‐H, Fixed, 95% CI)	1.33 [0.86, 2.04]

2.1 Sucralfate vs placebo	2	170	Risk Ratio (M‐H, Fixed, 95% CI)	1.43 [0.49, 4.16]
2.2 Sucralfate vs no prophylaxis	2	280	Risk Ratio (M‐H, Fixed, 95% CI)	1.30 [0.82, 2.07]
3 All‐cause mortality in ICU Show forest plot	5	500	Risk Ratio (M‐H, Fixed, 95% CI)	0.97 [0.66, 1.43]

3.1 Sucralfate vs placebo	2	170	Risk Ratio (M‐H, Fixed, 95% CI)	0.92 [0.48, 1.80]
3.2 Sucralfate vs no prophylaxis	3	330	Risk Ratio (M‐H, Fixed, 95% CI)	0.99 [0.62, 1.60]
4 All‐cause mortality in hospital Show forest plot	2	344	Risk Ratio (M‐H, Fixed, 95% CI)	0.97 [0.62, 1.52]

4.1 Sucralfate vs placebo	1	144	Risk Ratio (M‐H, Fixed, 95% CI)	1.09 [0.54, 2.18]
4.2 Sucralfate vs no prophylaxis	1	200	Risk Ratio (M‐H, Fixed, 95% CI)	0.89 [0.49, 1.62]
5 Duration of ICU stay Show forest plot	2	224	Mean Difference (IV, Fixed, 95% CI)	‐0.02 [‐1.70, 1.65]

5.1 Sucralfate vs placebo	1	144	Mean Difference (IV, Fixed, 95% CI)	‐0.70 [‐4.07, 2.67]
5.2 Sucralfate vs no prophylaxis	1	80	Mean Difference (IV, Fixed, 95% CI)	0.20 [‐1.73, 2.13]
6 Duration of intubation Show forest plot	2	224	Mean Difference (IV, Fixed, 95% CI)	1.42 [‐0.27, 3.10]

6.1 Sucralfate vs placebo	1	144	Mean Difference (IV, Fixed, 95% CI)	0.80 [‐2.20, 3.80]
6.2 Sucralfate vs no prophylaxis	1	80	Mean Difference (IV, Fixed, 95% CI)	1.70 [‐0.34, 3.74]
7 Number of participants requiring blood transfusions Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

7.1 Sucralfate vs no prophylaxis	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Units of blood transfused Show forest plot	1	200	Mean Difference (IV, Fixed, 95% CI)	0.8 [0.32, 1.28]

8.1 Sucralfate vs no prophylaxis	1	200	Mean Difference (IV, Fixed, 95% CI)	0.8 [0.32, 1.28]
9 Adverse events of interventions Show forest plot	1	70	Risk Ratio (M‐H, Fixed, 95% CI)	9.0 [0.50, 161.13]

9.1 Nausea / Vomiting	1	70	Risk Ratio (M‐H, Fixed, 95% CI)	9.0 [0.50, 161.13]

Comparison 8. Sucralfate versus placebo or no prophylaxis

Ir a la tabla de la revisión

Comparison 9. H2 receptor antagonists versus proton pump inhibitors

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	13	1636	Risk Ratio (M‐H, Fixed, 95% CI)	2.90 [1.83, 4.58]

1.1 Cimetidine vs omeprazole	1	359	Risk Ratio (M‐H, Fixed, 95% CI)	1.40 [0.55, 3.61]
1.2 Famotidine vs lansoprazole	1	51	Risk Ratio (M‐H, Fixed, 95% CI)	3.63 [0.15, 84.98]
1.3 Famotidine vs omeprazole	1	143	Risk Ratio (M‐H, Fixed, 95% CI)	2.03 [0.19, 21.87]
1.4 Famotidine vs pantoprazole	2	159	Risk Ratio (M‐H, Fixed, 95% CI)	0.73 [0.18, 3.04]
1.5 Famotidine vs esomeprazole	2	371	Risk Ratio (M‐H, Fixed, 95% CI)	7.53 [1.39, 40.85]
1.6 Ranitidine vs omeprazole	5	413	Risk Ratio (M‐H, Fixed, 95% CI)	4.08 [1.99, 8.36]
1.7 Ranitidine vs rabeprazole	1	140	Risk Ratio (M‐H, Fixed, 95% CI)	9.0 [0.49, 164.09]
2 Nosocomial pneumonia Show forest plot	10	1256	Risk Ratio (M‐H, Fixed, 95% CI)	1.02 [0.77, 1.35]

2.1 Cimetidine vs omeprazole	1	359	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.45, 1.54]
2.2 Cimetidine vs pantoprazole	1	202	Risk Ratio (M‐H, Fixed, 95% CI)	0.89 [0.28, 2.91]
2.3 Famotidine vs esomeprazole	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.07, 15.26]
2.4 Famotidine vs omeprazole	1	143	Risk Ratio (M‐H, Fixed, 95% CI)	0.89 [0.34, 2.32]
2.5 Ranitidine vs omeprazole	5	413	Risk Ratio (M‐H, Fixed, 95% CI)	1.19 [0.80, 1.75]
2.6 H2 receptor antagonists (not defined) vs proton pump inhibitors (not defined)	1	79	Risk Ratio (M‐H, Fixed, 95% CI)	1.03 [0.47, 2.26]
3 All‐cause mortality in ICU Show forest plot	12	1564	Risk Ratio (M‐H, Fixed, 95% CI)	0.96 [0.78, 1.19]

3.1 Cimetidine vs omeprazole	1	359	Risk Ratio (M‐H, Fixed, 95% CI)	0.76 [0.45, 1.30]
3.2 Cimetidine vs pantoprazole	1	202	Risk Ratio (M‐H, Fixed, 95% CI)	0.80 [0.25, 2.55]
3.3 Famotidine vs omeprazole	1	143	Risk Ratio (M‐H, Fixed, 95% CI)	1.13 [0.49, 2.61]
3.4 Ranitidine vs omeprazole	5	387	Risk Ratio (M‐H, Fixed, 95% CI)	1.10 [0.86, 1.40]
3.5 Ranitidine vs pantoprazole	3	333	Risk Ratio (M‐H, Fixed, 95% CI)	0.66 [0.31, 1.43]
3.6 Ranitidine vs rabeprazole	1	140	Risk Ratio (M‐H, Fixed, 95% CI)	3.0 [0.12, 72.40]
4 All‐cause mortality in hospital Show forest plot	2	454	Risk Ratio (M‐H, Fixed, 95% CI)	0.72 [0.37, 1.43]

4.1 Famotidine vs esomeprazole	1	311	Risk Ratio (M‐H, Fixed, 95% CI)	0.37 [0.04, 3.49]
4.2 Famotidine vs omeprazole	1	143	Risk Ratio (M‐H, Fixed, 95% CI)	0.80 [0.39, 1.63]
5 Duration of ICU stay Show forest plot	5	482	Mean Difference (IV, Fixed, 95% CI)	0.14 [‐1.14, 1.41]

5.1 Famotidine vs esomeprazole	1	60	Mean Difference (IV, Fixed, 95% CI)	‐0.30 [‐6.51, 5.91]
5.2 Famotidine vs omeprazole	1	143	Mean Difference (IV, Fixed, 95% CI)	2.40 [‐0.44, 5.24]
5.3 Ranitidine vs omeprazole	3	279	Mean Difference (IV, Fixed, 95% CI)	‐0.44 [‐1.90, 1.02]
6 Duration of intubation Show forest plot	5	542	Mean Difference (IV, Fixed, 95% CI)	‐0.35 [‐1.48, 0.78]

6.1 Famotidine vs omeprazole	1	143	Mean Difference (IV, Fixed, 95% CI)	0.70 [‐2.24, 3.64]
6.2 Ranitidine vs omeprazole	3	279	Mean Difference (IV, Fixed, 95% CI)	‐0.78 [‐2.24, 0.67]
6.3 Ranitidine vs pantoprazole	1	120	Mean Difference (IV, Fixed, 95% CI)	0.07 [‐2.18, 2.32]
7 Number of participants requiring blood transfusions Show forest plot	3	575	Risk Ratio (M‐H, Fixed, 95% CI)	1.98 [0.75, 5.21]

7.1 Cimetidine vs omeprazole	1	359	Risk Ratio (M‐H, Fixed, 95% CI)	0.98 [0.29, 3.34]
7.2 Ranitidine vs omeprazole	1	76	Risk Ratio (M‐H, Fixed, 95% CI)	5.0 [0.25, 100.80]
7.3 Ranitidine vs rabeprazole	1	140	Risk Ratio (M‐H, Fixed, 95% CI)	9.0 [0.49, 164.09]
8 Adverse events of interventions Show forest plot	5		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

8.1 Pyrexia	1	202	Risk Ratio (M‐H, Fixed, 95% CI)	0.93 [0.05, 19.03]
8.2 Thrombocytopaenia	2	253	Risk Ratio (M‐H, Fixed, 95% CI)	3.64 [0.65, 20.46]
8.3 Neuroleptic malignant syndrome	1	202	Risk Ratio (M‐H, Fixed, 95% CI)	1.56 [0.06, 37.42]
8.4 Cholestatic jaundice	1	202	Risk Ratio (M‐H, Fixed, 95% CI)	1.56 [0.06, 37.42]
8.5 Abnormal liver function test	1	202	Risk Ratio (M‐H, Fixed, 95% CI)	1.56 [0.06, 37.42]
8.6 Pruritus	1	202	Risk Ratio (M‐H, Fixed, 95% CI)	1.56 [0.06, 37.42]
8.7 Phlebitis	1	202	Risk Ratio (M‐H, Fixed, 95% CI)	1.56 [0.06, 37.42]
8.8 Major CV events	1	311	Risk Ratio (M‐H, Fixed, 95% CI)	0.79 [0.26, 2.43]
8.9 Abdominal distension and vomiting	1	90	Risk Ratio (M‐H, Fixed, 95% CI)	1.15 [0.62, 2.14]
8.10 Hypomagnesaemia	1	129	Risk Ratio (M‐H, Fixed, 95% CI)	0.43 [0.16, 1.13]
8.11 Nausea and vomiting	1	129	Risk Ratio (M‐H, Fixed, 95% CI)	0.48 [0.13, 1.77]
8.12 Diarrhoea	1	129	Risk Ratio (M‐H, Fixed, 95% CI)	1.11 [0.16, 7.67]

Comparison 9. H2 receptor antagonists versus proton pump inhibitors

Ir a la tabla de la revisión

Comparison 10. H2 receptor antagonists versus antacids

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	16	1700	Risk Ratio (M‐H, Random, 95% CI)	0.96 [0.67, 1.36]

1.1 Cimetidine vs antacids	11	1155	Risk Ratio (M‐H, Random, 95% CI)	1.07 [0.65, 1.78]
1.2 Cimetidine + pirenzepine vs antacid + pirenzepine	1	66	Risk Ratio (M‐H, Random, 95% CI)	1.0 [0.15, 6.68]
1.3 Ranitidine vs antacids	4	479	Risk Ratio (M‐H, Random, 95% CI)	0.72 [0.42, 1.23]
2 Nosocomial pneumonia Show forest plot	4	581	Risk Ratio (M‐H, Fixed, 95% CI)	1.05 [0.81, 1.36]

2.1 Cimetidine vs antacids	2	136	Risk Ratio (M‐H, Fixed, 95% CI)	1.24 [0.70, 2.19]
2.2 Ranitidine vs antacids	2	445	Risk Ratio (M‐H, Fixed, 95% CI)	1.00 [0.75, 1.34]
3 All‐cause mortality in ICU Show forest plot	11	1321	Risk Ratio (M‐H, Random, 95% CI)	1.01 [0.66, 1.55]

3.1 Cimetidine vs antacids	8	885	Risk Ratio (M‐H, Random, 95% CI)	1.05 [0.69, 1.59]
3.2 Cimetidine + pirenzepine vs antacid + pirenzepine	1	66	Risk Ratio (M‐H, Random, 95% CI)	1.25 [0.37, 4.25]
3.3 Ranitidine vs antacids	2	370	Risk Ratio (M‐H, Random, 95% CI)	1.13 [0.14, 8.97]
4 All‐cause mortality in hospital Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

4.1 Ranitidine vs antacids	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Duration of intubation Show forest plot	3	121	Mean Difference (IV, Random, 95% CI)	‐0.81 [‐3.85, 2.23]

5.1 Cimetidine vs antacids	3	121	Mean Difference (IV, Random, 95% CI)	‐0.81 [‐3.85, 2.23]
6 Number of participants requiring blood transfusions Show forest plot	6	744	Risk Ratio (M‐H, Fixed, 95% CI)	2.49 [1.35, 4.62]

6.1 Cimetidine vs antacids	5	583	Risk Ratio (M‐H, Fixed, 95% CI)	2.47 [1.32, 4.63]
6.2 Ranitidine vs antacids	1	161	Risk Ratio (M‐H, Fixed, 95% CI)	3.04 [0.13, 73.46]
7 Adverse events of interventions Show forest plot	12		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

7.1 Diarrhoea	6	777	Risk Ratio (M‐H, Fixed, 95% CI)	0.23 [0.13, 0.43]
7.2 Thrombocytopaenia	4	452	Risk Ratio (M‐H, Fixed, 95% CI)	1.40 [0.93, 2.09]
7.3 Nausea and vomiting	4	380	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.19, 1.10]
7.4 Hypophosphataemia	2	108	Risk Ratio (M‐H, Fixed, 95% CI)	0.24 [0.04, 1.30]
7.5 Hypomagnesaemia	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.33 [0.02, 7.39]
7.6 Increase in creatinine	2	286	Risk Ratio (M‐H, Fixed, 95% CI)	0.85 [0.56, 1.28]
7.7 Mental confusion	4	476	Risk Ratio (M‐H, Fixed, 95% CI)	1.26 [0.77, 2.07]
7.8 Hypermagnesaemia	2	115	Risk Ratio (M‐H, Fixed, 95% CI)	0.58 [0.17, 2.03]
7.9 Rash/Erythema	2	231	Risk Ratio (M‐H, Fixed, 95% CI)	3.02 [0.32, 28.53]
7.10 Alkalosis	1	75	Risk Ratio (M‐H, Fixed, 95% CI)	0.32 [0.01, 7.73]
7.11 Dryness of mouth	1	67	Risk Ratio (M‐H, Fixed, 95% CI)	5.15 [0.26, 103.33]
7.12 Leucopaenia	1	161	Risk Ratio (M‐H, Fixed, 95% CI)	3.04 [0.13, 73.46]

Comparison 10. H2 receptor antagonists versus antacids

Ir a la tabla de la revisión

Comparison 11. H2 receptor antagonists versus sucralfate

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	24	3316	Risk Ratio (M‐H, Fixed, 95% CI)	1.10 [0.87, 1.41]

1.1 Cimetidine vs sucralfate	7	873	Risk Ratio (M‐H, Fixed, 95% CI)	1.37 [0.87, 2.14]
1.2 Famotidine vs sucralfate	2	190	Risk Ratio (M‐H, Fixed, 95% CI)	0.62 [0.21, 1.78]
1.3 Ranitidine vs sucralfate	14	2186	Risk Ratio (M‐H, Fixed, 95% CI)	1.03 [0.76, 1.39]
1.4 Cimetidine + pirenzepine vs sucralfate + pirenzepine	1	67	Risk Ratio (M‐H, Fixed, 95% CI)	5.15 [0.26, 103.33]
2 Nosocomial pneumonia Show forest plot	17	3041	Risk Ratio (M‐H, Fixed, 95% CI)	1.22 [1.07, 1.40]

2.1 Cimetidine vs sucralfate	5	758	Risk Ratio (M‐H, Fixed, 95% CI)	1.13 [0.87, 1.47]
2.2 Famotidine vs sucralfate	1	140	Risk Ratio (M‐H, Fixed, 95% CI)	1.13 [0.40, 3.20]
2.3 Ranitidine vs sucralfate	11	2143	Risk Ratio (M‐H, Fixed, 95% CI)	1.26 [1.07, 1.48]
3 All‐cause mortality in ICU Show forest plot	21	3178	Risk Ratio (M‐H, Fixed, 95% CI)	1.09 [0.95, 1.24]

3.1 Cimetidine vs sucralfate	6	814	Risk Ratio (M‐H, Fixed, 95% CI)	1.18 [0.91, 1.54]
3.2 Famotidine vs sucralfate	2	190	Risk Ratio (M‐H, Fixed, 95% CI)	1.23 [0.69, 2.19]
3.3 Ranitidine vs sucralfate	12	2107	Risk Ratio (M‐H, Fixed, 95% CI)	1.04 [0.88, 1.22]
3.4 Cimetidine + pirenzepine vs sucralfate + pirenzepine	1	67	Risk Ratio (M‐H, Fixed, 95% CI)	1.29 [0.38, 4.38]
4 All‐cause mortality in hospital Show forest plot	4	717	Risk Ratio (M‐H, Fixed, 95% CI)	1.14 [0.86, 1.50]

4.1 Cimetidine vs sucralfate	2	413	Risk Ratio (M‐H, Fixed, 95% CI)	1.28 [0.86, 1.92]
4.2 Ranitidine vs sucralfate	1	164	Risk Ratio (M‐H, Fixed, 95% CI)	1.11 [0.71, 1.74]
4.3 Famotidine vs sucralfate	1	140	Risk Ratio (M‐H, Fixed, 95% CI)	0.82 [0.40, 1.71]
5 Duration of intubation Show forest plot	10	1751	Mean Difference (IV, Random, 95% CI)	0.22 [‐1.55, 2.00]

5.1 Cimetidine vs sucralfate	2	97	Mean Difference (IV, Random, 95% CI)	0.58 [‐1.71, 2.87]
5.2 Famotidine vs sucralfate	1	140	Mean Difference (IV, Random, 95% CI)	0.40 [‐2.30, 3.10]
5.3 Ranitidine vs sucralfate	7	1514	Mean Difference (IV, Random, 95% CI)	0.15 [‐2.12, 2.43]
6 Duration of ICU stay Show forest plot	6	1791	Mean Difference (IV, Random, 95% CI)	0.01 [‐1.92, 1.95]

6.1 Cimetidine vs sucralfate	1	213	Mean Difference (IV, Random, 95% CI)	0.0 [‐3.05, 3.05]
6.2 Famotidine vs sucralfate	1	140	Mean Difference (IV, Random, 95% CI)	2.20 [‐0.96, 5.36]
6.3 Ranitidine vs sucralfate	4	1438	Mean Difference (IV, Random, 95% CI)	‐0.43 [‐2.70, 1.84]
7 Number of participants requiring blood transfusion Show forest plot	9	1095	Risk Ratio (M‐H, Fixed, 95% CI)	1.25 [0.70, 2.23]

7.1 Cimetidine vs sucralfate	5	732	Risk Ratio (M‐H, Fixed, 95% CI)	1.00 [0.47, 2.16]
7.2 Ranitidine vs sucralfate	4	363	Risk Ratio (M‐H, Fixed, 95% CI)	1.77 [0.71, 4.39]
8 Units of blood transfused Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

8.1 Cimetidine vs sucralfate	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
9 Adverse events of interventions Show forest plot	6		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

9.1 Thrombocytopaenia	2	240	Risk Ratio (M‐H, Fixed, 95% CI)	4.72 [0.56, 39.47]
9.2 Nausea and vomiting	2	137	Risk Ratio (M‐H, Fixed, 95% CI)	0.07 [0.01, 0.54]
9.3 Hypermagnesaemia	1	40	Risk Ratio (M‐H, Fixed, 95% CI)	2.71 [0.31, 23.93]
9.4 Rash/Erythema	2	233	Risk Ratio (M‐H, Fixed, 95% CI)	3.06 [0.32, 28.87]
9.5 Confusion	3	382	Risk Ratio (M‐H, Fixed, 95% CI)	4.48 [0.77, 26.00]
9.6 Neutropaenia	1	114	Risk Ratio (M‐H, Fixed, 95% CI)	5.18 [0.25, 105.47]
9.7 Dryness of mouth	1	67	Risk Ratio (M‐H, Fixed, 95% CI)	5.15 [0.26, 103.33]
9.8 Leucopaenia	1	163	Risk Ratio (M‐H, Fixed, 95% CI)	3.11 [0.13, 75.26]

Comparison 11. H2 receptor antagonists versus sucralfate

Ir a la tabla de la revisión

Comparison 12. H2 receptor antagonists versus anticholinergics

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	3	556	Risk Ratio (M‐H, Fixed, 95% CI)	1.37 [0.58, 3.26]

1.1 Cimetidine vs pirenzepine	1	55	Risk Ratio (M‐H, Fixed, 95% CI)	1.45 [0.26, 7.99]
1.2 Ranitidine vs pirenzepine	2	501	Risk Ratio (M‐H, Fixed, 95% CI)	1.35 [0.50, 3.67]
2 Nosocomial pneumonia Show forest plot	3	544	Risk Ratio (M‐H, Fixed, 95% CI)	0.96 [0.50, 1.84]

2.1 Famotidine vs pirenzepine	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.32 [0.01, 7.42]
2.2 Ranitidine vs pirenzepine	2	501	Risk Ratio (M‐H, Fixed, 95% CI)	1.03 [0.53, 2.01]
3 All‐cause mortality in ICU Show forest plot	2	501	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.21, 3.87]

3.1 Ranitidine vs pirenzepine	2	501	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.21, 3.87]
4 Number of participants requiring blood transfusion Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

4.1 Ranitidine vs pirenzepine	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Adverse events of interventions Show forest plot	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

5.1 Tachycardia	1	55	Risk Ratio (M‐H, Fixed, 95% CI)	0.11 [0.01, 1.90]
5.2 High temperature	1	43	Risk Ratio (M‐H, Fixed, 95% CI)	0.53 [0.21, 1.32]

Comparison 12. H2 receptor antagonists versus anticholinergics

Ir a la tabla de la revisión

Comparison 13. H2 receptor antagonists versus prostaglandin analogues

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

1.1 Cimetidine vs misoprostol	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 All‐cause mortality in ICU Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2.1 Cimetidine vs misoprostol	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 13. H2 receptor antagonists versus prostaglandin analogues

Ir a la tabla de la revisión

Comparison 14. H2 receptor antagonists versus teprenone

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

1.1 Ranitidine vs teprenone	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 All‐cause mortality in ICU Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2.1 Ranitidine vs teprenone	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Number of participants requiring blood transfusion Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3.1 Ranitidine vs teprenone	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 14. H2 receptor antagonists versus teprenone

Ir a la tabla de la revisión

Comparison 15. H2 receptor antagonist + antacids versus sucralfate

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	2	230	Risk Ratio (M‐H, Fixed, 95% CI)	0.24 [0.06, 0.95]

1.1 Cimetidine + antacids vs sucralfate	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.14 [0.01, 2.70]
1.2 Cimetidine or ranitidine + antacids vs sucralfate	1	130	Risk Ratio (M‐H, Fixed, 95% CI)	0.29 [0.06, 1.41]
2 Nosocomial pneumonia Show forest plot	3	281	Risk Ratio (M‐H, Random, 95% CI)	1.09 [0.51, 2.32]

2.1 Cimetidine + antacids vs sucralfate	1	100	Risk Ratio (M‐H, Random, 95% CI)	0.53 [0.26, 1.07]
2.2 Ranitidine + antacids vs sucralfate	1	51	Risk Ratio (M‐H, Random, 95% CI)	1.27 [0.64, 2.53]
2.3 Cimetidine or ranitidine + antacids vs sucralfate	1	130	Risk Ratio (M‐H, Random, 95% CI)	2.02 [0.89, 4.58]
3 All‐cause mortality in ICU Show forest plot	2	230	Risk Ratio (M‐H, Fixed, 95% CI)	1.38 [0.92, 2.05]

3.1 Cimetidine + antacids vs sucralfate	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.46, 2.19]
3.2 Cimetidine or ranitidine + antacids vs sucralfate	1	130	Risk Ratio (M‐H, Fixed, 95% CI)	1.57 [0.99, 2.50]
4 Duration of ICU stay Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

5 Duration of intubation Show forest plot	2	230	Mean Difference (IV, Random, 95% CI)	‐1.24 [‐13.82, 11.33]

5.1 Cimetidine + antacids vs sucralfate	1	100	Mean Difference (IV, Random, 95% CI)	‐8.8 [‐20.11, 2.51]
5.2 Cimetidine or ranitidine + antacids vs sucralfate	1	130	Mean Difference (IV, Random, 95% CI)	4.20 [‐0.54, 8.94]
6 Number of participants requiring blood transfusion Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 15. H2 receptor antagonist + antacids versus sucralfate

Ir a la tabla de la revisión

Comparison 16. Proton pump inhibitors versus teprenone

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

1.1 Proton pump inhibitors vs teprenone	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 All‐cause mortality in ICU Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2.1 Proton pump inhibitors vs teprenone	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Number of participants requiring blood transfusion Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3.1 Proton pump inhibitors vs teprenone	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 16. Proton pump inhibitors versus teprenone

Ir a la tabla de la revisión

Comparison 17. Proton pump inhibitor plus naloxone versus naloxone

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2 All‐cause mortality in hospital Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3 Adverse events ‐ gastrointestinal discomfort Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 17. Proton pump inhibitor plus naloxone versus naloxone

Ir a la tabla de la revisión

Comparison 18. Proton pump inhibitors versus other medication (not defined)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2 Nosocomial pneumonia Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3 All‐cause mortality in hospital Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 18. Proton pump inhibitors versus other medication (not defined)

Ir a la tabla de la revisión

Comparison 19. Antacids versus sucralfate

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	16	1772	Risk Ratio (M‐H, Fixed, 95% CI)	1.00 [0.72, 1.39]

1.1 Antacids vs sucralfate	15	1705	Risk Ratio (M‐H, Fixed, 95% CI)	0.96 [0.69, 1.35]
1.2 Antacid + pirenzepine vs sucralfate + pirenzepine	1	67	Risk Ratio (M‐H, Fixed, 95% CI)	5.15 [0.26, 103.33]
2 Nosocomial pneumonia Show forest plot	7		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

2.1 Antacids vs sucralfate	7	996	Risk Ratio (M‐H, Fixed, 95% CI)	1.04 [0.84, 1.30]
3 All‐cause mortality in ICU Show forest plot	11	1249	Risk Ratio (M‐H, Fixed, 95% CI)	1.15 [0.93, 1.40]

3.1 Antacid vs sucralfate	10	1182	Risk Ratio (M‐H, Fixed, 95% CI)	1.15 [0.94, 1.41]
3.2 Antacid + pirenzepine vs sucralfate + pirenzepine	1	67	Risk Ratio (M‐H, Fixed, 95% CI)	1.03 [0.28, 3.78]
4 All‐cause mortality in hospital Show forest plot	3	450	Risk Ratio (M‐H, Random, 95% CI)	0.98 [0.69, 1.39]

5 Duration of ICU stay Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

5.1 Antacids vs sucralfate	2	227	Mean Difference (IV, Fixed, 95% CI)	‐2.50 [‐6.61, 1.61]
6 Duration of intubation Show forest plot	4		Std. Mean Difference (IV, Fixed, 95% CI)	Subtotals only

6.1 Antacids vs sucralfate	4	281	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.18 [‐0.41, 0.06]
7 Number of participants requiring blood transfusion Show forest plot	6	667	Risk Ratio (M‐H, Fixed, 95% CI)	0.73 [0.40, 1.34]

8 Adverse events of interventions Show forest plot	9		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

8.1 Diarrhoea	6	599	Risk Ratio (M‐H, Fixed, 95% CI)	12.40 [3.88, 39.64]
8.2 Hypermagnesaemia	4	317	Risk Ratio (M‐H, Fixed, 95% CI)	4.72 [1.24, 17.95]
8.3 Nausea and vomiting	3	223	Risk Ratio (M‐H, Fixed, 95% CI)	0.63 [0.28, 1.41]
8.4 Thrombocytopaenia	1	38	Risk Ratio (M‐H, Fixed, 95% CI)	5.0 [0.26, 97.70]
8.5 Severe alkalosis	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	3.0 [0.13, 71.92]
8.6 Allergic reactions	1	100	Risk Ratio (M‐H, Fixed, 95% CI)	0.2 [0.01, 4.06]

Comparison 19. Antacids versus sucralfate

Ir a la tabla de la revisión

Comparison 20. Antacids versus prostaglandin analogues

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	2	329	Risk Ratio (M‐H, Fixed, 95% CI)	0.33 [0.12, 0.91]

2 All‐cause mortality in ICU Show forest plot	2	417	Risk Ratio (M‐H, Fixed, 95% CI)	0.84 [0.42, 1.67]

3 Adverse events of interventions Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

3.1 Diarrhoea	1	368	Risk Ratio (M‐H, Fixed, 95% CI)	0.92 [0.64, 1.33]
3.2 Elevated serum bicarbonate	1	338	Risk Ratio (M‐H, Fixed, 95% CI)	2.21 [1.27, 3.87]
3.3 Phospate levels < 2.5 mg/dL	1	276	Risk Ratio (M‐H, Fixed, 95% CI)	1.66 [1.01, 2.73]

Comparison 20. Antacids versus prostaglandin analogues

Ir a la tabla de la revisión

Comparison 21. Antacids versus bioflavonoids

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2 Number of participants requiring blood transfusion Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 21. Antacids versus bioflavonoids

Ir a la tabla de la revisión

Comparison 22. Sucralfate versus proton pump inhibitors

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	3		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

1.1 Sucralfate vs omeprazole	3	287	Risk Ratio (M‐H, Fixed, 95% CI)	2.58 [0.77, 8.63]
2 Nosocomial pneumonia Show forest plot	4	424	Risk Ratio (M‐H, Random, 95% CI)	0.67 [0.41, 1.09]

2.1 Sucralfate vs omeprazole	3	287	Risk Ratio (M‐H, Random, 95% CI)	0.88 [0.57, 1.36]
2.2 Sucralfate vs pantoprazole	1	137	Risk Ratio (M‐H, Random, 95% CI)	0.39 [0.20, 0.75]
3 All‐cause mortality in ICU Show forest plot	4	424	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.68, 1.68]

3.1 Sucralfate vs omeprazole	3	287	Risk Ratio (M‐H, Fixed, 95% CI)	1.26 [0.75, 2.11]
3.2 Sucralfate vs pantoprazole	1	137	Risk Ratio (M‐H, Fixed, 95% CI)	0.65 [0.25, 1.68]
4 All‐cause mortality in hospital Show forest plot	2	278	Risk Ratio (M‐H, Fixed, 95% CI)	0.79 [0.46, 1.37]

4.1 Sucralfate vs omeprazole	1	141	Risk Ratio (M‐H, Fixed, 95% CI)	0.97 [0.49, 1.91]
4.2 Sucralfate vs pantoprazole	1	137	Risk Ratio (M‐H, Fixed, 95% CI)	0.56 [0.21, 1.45]
5 Duration of ICU stay Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

5.1 Sucralfate vs omeprazole	2	217	Mean Difference (IV, Fixed, 95% CI)	0.01 [‐1.68, 1.70]
6 Duration of intubation Show forest plot	3	354	Mean Difference (IV, Fixed, 95% CI)	‐0.16 [‐1.61, 1.28]

6.1 Sucralfate vs omeprazole	2	217	Mean Difference (IV, Fixed, 95% CI)	0.02 [‐1.56, 1.60]
6.2 Sucralfate vs pantoprazole	1	137	Mean Difference (IV, Fixed, 95% CI)	‐1.10 [‐4.69, 2.49]
7 Number of participants requiring blood transfusion Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

7.1 Sucralfate vs omeprazole	1	70	Risk Ratio (M‐H, Fixed, 95% CI)	5.91 [0.29, 118.78]
8 Adverse events of interventions Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only

8.1 Fever	1	137	Risk Ratio (M‐H, Random, 95% CI)	0.81 [0.70, 0.94]
8.2 Leucocytosis	1	137	Risk Ratio (M‐H, Random, 95% CI)	0.66 [0.55, 0.80]
8.3 Sudden purulent sputum	1	137	Risk Ratio (M‐H, Random, 95% CI)	0.85 [0.38, 1.86]
8.4 Sudden cough or aggravation of coughing	1	137	Risk Ratio (M‐H, Random, 95% CI)	0.23 [0.07, 0.79]
8.5 Dyspnoea	1	137	Risk Ratio (M‐H, Random, 95% CI)	0.68 [0.54, 0.87]
8.6 Rales or bronchial sounds	1	137	Risk Ratio (M‐H, Random, 95% CI)	0.31 [0.19, 0.51]
8.7 Aggravation of blood gas exchange	1	137	Risk Ratio (M‐H, Random, 95% CI)	0.76 [0.49, 1.18]
8.8 Change in sputum quality	1	137	Risk Ratio (M‐H, Random, 95% CI)	0.23 [0.13, 0.40]

Comparison 22. Sucralfate versus proton pump inhibitors

Ir a la tabla de la revisión

Comparison 23. Sucralfate versus bioflavonoids

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2 Number of participants requiring blood transfusion Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 23. Sucralfate versus bioflavonoids

Ir a la tabla de la revisión

Comparison 24. Total parenteral nutrition (TPN) versus any other intervention + TPN

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

1.1 TPN vs ranitidine + TPN	1	54	Risk Ratio (M‐H, Fixed, 95% CI)	0.8 [0.05, 12.14]
1.2 TPN vs sucralfate + TPN	1	49	Risk Ratio (M‐H, Fixed, 95% CI)	0.32 [0.03, 3.26]
2 All‐cause mortality in ICU Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

2.1 TPN vs ranitidine + TPN	1	54	Risk Ratio (M‐H, Fixed, 95% CI)	1.12 [0.41, 3.09]
2.2 TPN vs sucralfate + TPN	1	49	Risk Ratio (M‐H, Fixed, 95% CI)	0.63 [0.26, 1.52]
3 Duration of intubation Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

3.1 TPN vs ranitidine + TPN	1	54	Mean Difference (IV, Fixed, 95% CI)	‐2.0 [‐9.53, 5.53]
3.2 TPN vs sucralfate + TPN	1	49	Mean Difference (IV, Fixed, 95% CI)	3.0 [‐1.50, 7.50]

Comparison 24. Total parenteral nutrition (TPN) versus any other intervention + TPN

Ir a la tabla de la revisión

Comparison 25. Bowel stimulation versus no prophylaxis

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 25. Bowel stimulation versus no prophylaxis

Ir a la tabla de la revisión

Comparison 26. Nasojejunal nutrition versus nasogastric nutrition

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Clinically important upper GI bleeding Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2 Nosocomial pneumonia Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3 All‐cause mortality in hospital Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

4 Adverse events of interventions Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 26. Nasojejunal nutrition versus nasogastric nutrition

Ir a la tabla de la revisión

Comparison 27. Enteral plus parenteral nutrition versus other nutrition regimens

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Nosocomial pneumonia Show forest plot	1	120	Risk Ratio (M‐H, Fixed, 95% CI)	0.79 [0.44, 1.40]

1.1 Enteral plus parenteral nutrition vs enteral nutrition	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	0.6 [0.29, 1.25]
1.2 Enteral plus parenteral nutrition vs parenteral nutrition	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	1.25 [0.47, 3.33]
2 All‐cause mortality in hospital Show forest plot	1	120	Odds Ratio (M‐H, Fixed, 95% CI)	0.20 [0.06, 0.60]

2.1 Enteral plus parenteral nutrition vs enteral nutrition	1	60	Odds Ratio (M‐H, Fixed, 95% CI)	0.26 [0.05, 1.30]
2.2 Enteral plus parenteral nutrition vs parenteral nutrition	1	60	Odds Ratio (M‐H, Fixed, 95% CI)	0.15 [0.03, 0.74]
3 Duration of ICU stay Show forest plot	1	120	Mean Difference (IV, Fixed, 95% CI)	‐5.98 [‐8.81, ‐3.16]

3.1 Enteral plus parenteral nutrition vs enteral nutrition	1	60	Mean Difference (IV, Fixed, 95% CI)	‐3.81 [‐7.59, ‐0.03]
3.2 Enteral plus parenteral nutrition vs parenteral nutrition	1	60	Mean Difference (IV, Fixed, 95% CI)	‐8.72 [‐12.97, ‐4.47]
4 Duration of intubation Show forest plot	1	120	Mean Difference (IV, Fixed, 95% CI)	‐7.37 [‐9.29, ‐5.45]

4.1 Enteral plus parenteral nutrition vs enteral nutrition	1	60	Mean Difference (IV, Fixed, 95% CI)	‐4.17 [‐6.96, ‐1.38]
4.2 Enteral plus parenteral nutrition vs parenteral nutrition	1	60	Mean Difference (IV, Fixed, 95% CI)	‐10.24 [‐12.88, ‐7.60]
5 Adverse events ‐ stress ulcer Show forest plot	1	120	Risk Ratio (M‐H, Fixed, 95% CI)	0.69 [0.36, 1.33]

5.1 Enteral plus parenteral nutrition vs enteral nutrition	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	1.14 [0.38, 3.45]
5.2 Enteral plus parenteral nutrition vs parenteral nutrition	1	60	Risk Ratio (M‐H, Fixed, 95% CI)	0.53 [0.23, 1.20]
6 Adverse events ‐ diarrhoea Show forest plot	1	120	Odds Ratio (M‐H, Fixed, 95% CI)	0.42 [0.17, 1.02]

6.1 Enteral plus parenteral nutrition vs enteral nutrition	1	60	Odds Ratio (M‐H, Fixed, 95% CI)	0.17 [0.05, 0.59]
6.2 Enteral plus parenteral nutrition vs parenteral nutrition	1	60	Odds Ratio (M‐H, Fixed, 95% CI)	1.42 [0.35, 5.73]
7 Adverse events ‐ pyaemia Show forest plot	1	120	Odds Ratio (M‐H, Fixed, 95% CI)	0.88 [0.37, 2.09]

7.1 Enteral plus parenteral nutrition vs enteral nutrition	1	60	Odds Ratio (M‐H, Fixed, 95% CI)	4.11 [0.87, 19.41]
7.2 Enteral plus parenteral nutrition vs parenteral nutrition	1	60	Odds Ratio (M‐H, Fixed, 95% CI)	0.37 [0.11, 1.21]
8 Adverse events ‐ intracranial infection Show forest plot	1	120	Odds Ratio (M‐H, Fixed, 95% CI)	0.43 [0.15, 1.25]

8.1 Enteral plus parenteral nutrition vs enteral nutrition	1	60	Odds Ratio (M‐H, Fixed, 95% CI)	0.83 [0.19, 3.63]
8.2 Enteral plus parenteral nutrition vs parenteral nutrition	1	60	Odds Ratio (M‐H, Fixed, 95% CI)	0.23 [0.05, 1.15]
9 Adverse events ‐ hypoproteinaemia Show forest plot	1	120	Odds Ratio (M‐H, Fixed, 95% CI)	0.11 [0.04, 0.27]

9.1 Enteral plus parenteral nutrition vs enteral nutrition	1	60	Odds Ratio (M‐H, Fixed, 95% CI)	0.20 [0.06, 0.72]
9.2 Enteral plus parenteral nutrition vs parenteral nutrition	1	60	Odds Ratio (M‐H, Fixed, 95% CI)	0.04 [0.01, 0.19]

Comparison 27. Enteral plus parenteral nutrition versus other nutrition regimens

Ir a la tabla de la revisión

The Cochrane Library

Scolaris Language Selector Scolaris Language Selector

Idioma de la Revisión Cochrane

Idioma de la web

Scolaris Content Language Banner Portlet Scolaris Content Language Banner Portlet

Scolaris Content Display Scolaris Content Display

Temas

Scolaris Language Selector Scolaris Language Selector

Scolaris Content Display Scolaris Content Display

Instituciones a las que se accedió previamente

Scolaris Content Display Scolaris Content Display

Usuarios institucionales

Instituciones a las que se accedió previamente

Otras opciones de acceso

	Idioma de la Revisión Cochrane Escoja su idioma de preferencia para las revisiones Cochrane y otros contenidos. Las secciones sin una traducción aparecerán en inglés.

	Idioma de la web Escoja su idioma de preferencia para la web de la Biblioteca Cochrane.

Idioma de la Revisión Cochrane

Idioma de la web

Contenido relacionado

Revisiones y protocolos relacionados

Respuestas clínicas Cochrane

Temas

Copiar o descargar referencia

Idioma de la Revisión Cochrane

Idioma de la web

Instituciones a las que se accedió previamente

Usuarios institucionales

Instituciones a las que se accedió previamente

Otras opciones de acceso