Question special
Residents and Fellow

Previous studies in the early 2000’s have shown increased mortality and length of ICU stay among those patients with clinically important GI bleed. However, in the literature starting in mid 2010’s, the same effect has diminished. Although there is a statistical significance on reduction on clinically important GI bleed, a number of meta-analysis show there’s no longer a statistically significance of mortality among those treated with PPI’s. Would this effect be partially explained by the change of ICU practice from early 2000’s to mid-2010’s (i.e implementation of early-goal directed therapy leading to less hypotension (and more gastric perfusion)? Or earlier recognition of SIRS / sepsis?)