{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T22:27:46Z","timestamp":1790634466744,"version":"4.1.0"},"reference-count":17,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1986,2]]},"abstract":"<jats:p>The efficacy of cimetidine in the prevention of gastrointestinal haemorrhage in a general intensive care unit was evaluated in 221 patients by a placebo controlled double blind randomised study. Criteria for bleeding were (i) haematemesis or gastric aspirate greater than 50 ml fresh blood, (ii) melaena or fresh blood per rectum with an upper source verified by endoscopy if the gastric aspirate was clear, (iii) a fall in haemoglobin level greater than 2 g\/dl in a 24 hour period associated with either 4+ occult blood in stools, or coffee ground gastric drainage of at least 100 ml. The drug and placebo groups were similar for age, sex, duration of study and risk factors. One hundred and fourteen received cimetidine and 107 placebo. Only 8% of the patients bled with no significant difference between the two groups (6\/114 cimetidine, 11\/107 placebo; p = 0.16). There was no correlation between the frequency of bleeding and either the number of risk factors per patient or the duration of intensive care unit stay. Thirteen patients died in each study group, resulting in overall mortality of 12%. The low incidence of haemorrhage, the lack of statistical benefit from cimetidine and the similar mortality all argue against the routine use of this drug in intensive care unit patients.<\/jats:p>","DOI":"10.1136\/gut.27.2.135","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"135-140","source":"Crossref","is-referenced-by-count":50,"title":["Cimetidine prophylaxis for gastrointestinal bleeding in an intensive care unit."],"prefix":"10.1136","volume":"27","author":[{"given":"A","family":"Groll","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J B","family":"Simon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R D","family":"Wigle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Taguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R J","family":"Todd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W T","family":"Depew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1986,2,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1056\/NEJM197410312911801","article-title":"Acute gastroduodenal disease after thermal injury","volume":"291","author":"Czala, A.G.; McAlhany, M.C.; Pruitt, B.A.","year":"1974","unstructured":"Czala AG, McAlhany MC, Pruitt BA. Acute gastroduodenal disease after thermal injury. N Engl J Med 1974; 291: 925-9.","journal-title":"N Engl J Med"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1146\/annurev.me.27.020176.000301","article-title":"Stress ulceration in the acutely ill","volume":"27","author":"Skillman, J.J.; Silen, W.","year":"1976","unstructured":"Skillman JJ, Silen W. Stress ulceration in the acutely ill. Ann Rev Med 1976; 27: 9-22.","journal-title":"Ann Rev Med"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1001\/archsurg.1971.01350040028006","article-title":"Natural history and surgical dilemma of 'stress' gastric bleeding","volume":"102","author":"Lucas, C.E.; Sugawa, C.; Riddle, J.; Rector, F.; Rosenberg, B.; Walt, A.J.","year":"1971","unstructured":"Lucas CE, Sugawa C, Riddle J, Rector F, Rosenberg B, Walt AJ. Natural history and surgical dilemma of 'stress' gastric bleeding. Arch Surg 1971; 102: 266-73.","journal-title":"Arch Surg"},{"key":"ref_4","first-page":"523","article-title":"Respiratory failure, hypotension, sepsis and jaundice, a clinical syndrome associated with lethal haemorrhage from acute stress ulceration of the stomach","volume":"117","author":"Skillman, J.J.; Bushnell, L.S.; Goldman, H.; Silen, W.","year":"1969","unstructured":"Skillman JJ, Bushnell LS, Goldman H, Silen W. Respiratory failure, hypotension, sepsis and jaundice, a clinical syndrome associated with lethal haemorrhage from acute stress ulceration of the stomach. Am J Surg 1969; 117: 523-30.","journal-title":"Am J Surg"},{"key":"ref_5","first-page":"154","article-title":"Hydrogen permeability of canine gastric secretory epithelium during formation of superficial erosions","volume":"70","author":"Moody, F.G.; Aldrete, J.S.","year":"1971","unstructured":"Moody FG, Aldrete JS. Hydrogen permeability of canine gastric secretory epithelium during formation of superficial erosions. Surgery 1971; 70: 154-60.","journal-title":"Surgery"},{"key":"ref_6","first-page":"46","article-title":"Mechanism of stress ulcers: influence of hypovolemic shock on energy metabolism","volume-title":"the gastric mucosa. Gastroenterology","volume":"66","author":"Menguy, R.; Desbaillets, L.; Masters, Y.F.","year":"1974","unstructured":"Menguy R, Desbaillets L, Masters YF. Mechanism of stress ulcers: influence of hypovolemic shock on energy metabolism in the gastric mucosa. Gastroenterology 1974; 66: 46-56."},{"key":"ref_7","first-page":"214","article-title":"The prevention of upper gastrointestinal tract bleeding in patients in an intensive care unit","volume":"153","author":"Zinner, M.J.; Zuidema, G.D.; Smith, P.L.; Mignosa, M.","year":"1981","unstructured":"Zinner MJ, Zuidema GD, Smith PL, Mignosa M. The prevention of upper gastrointestinal tract bleeding in patients in an intensive care unit. Surg Obst Gynecol 1981; 153: 214-20.","journal-title":"Surg Obst Gynecol"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/S0140-6736(77)92055-4","article-title":"H2-receptor antagonists and antacids in the prevention of acute gastrointestinal haemorrhage in fulminant hepatic failure","volume":"1","author":"MacDougall, B.R.D.; Bailey, R.J.; Williams, R.","year":"1977","unstructured":"MacDougall BRD, Bailey RJ, Williams R. H2-receptor antagonists and antacids in the prevention of acute gastrointestinal haemorrhage in fulminant hepatic failure. Lancet 1977; 1: 617-9.","journal-title":"Lancet"},{"key":"ref_9","first-page":"316","article-title":"Prophylaxis of upper gastrointestinal haemorrhage in patients requiring mechanical ventilation","volume":"10","author":"Friedman, C.J.; Oblinger, M.J.; Suratt, P.M.","year":"1982","unstructured":"Friedman CJ, Oblinger MJ, Suratt PM et al. Prophylaxis of upper gastrointestinal haemorrhage in patients requiring mechanical ventilation. Crit Care Med 1982; 10: 316-9.","journal-title":"Crit Care Med"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/0002-9610(81)90191-4","article-title":"Cimetidine and antacid prophylaxis of acute upper gastrointestinal bleeding in high risk patients","volume":"141","author":"Basso, N.; Bagarani, M.; Materia, A.; Fiorani, S.; Lunardi, P.; Speranzo, V.","year":"1981","unstructured":"Basso N, Bagarani M, Materia A, Fiorani S, Lunardi P, Speranzo V. Cimetidine and antacid prophylaxis of acute upper gastrointestinal bleeding in high risk patients. Am J Surg 1981; 141: 339-41.","journal-title":"Am J Surg"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/0002-9610(80)90228-7","article-title":"Prevention of acute gastrointestinal complications after severe head injury. A controlled trial of cimetidine prophylaxis","volume":"139","author":"Halloran, L.G.; Zfass, A.M.; Gayle, W.E.; Wheeler, C.B.; Miller, J.D.","year":"1980","unstructured":"Halloran LG, Zfass AM, Gayle WE, Wheeler CB, Miller JD. Prevention of acute gastrointestinal complications after severe head injury. A controlled trial of cimetidine prophylaxis. Am J Surg 1980; 139: 44-8.","journal-title":"Am J Surg"},{"key":"ref_12","first-page":"168","article-title":"Inference on proportions","volume-title":"Statistics in medicine","author":"Colton, T.","year":"1974","unstructured":"Colton T. Inference on proportions. In: Colton T, ed. Statistics in medicine. Boston: Little Brown 1974: 168-9."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1056\/NEJM197805112981901","article-title":"Antacid titration in the prevention of acute gastrointestinal bleeding. A controlled randomised trial in 100 critically ill patients","volume":"298","author":"Hastings, P.R.; Skillman, J.J.; Bushnell, L.S.; Silen, W.","year":"1978","unstructured":"Hastings PR, Skillman JJ, Bushnell LS, Silen W. Antacid titration in the prevention of acute gastrointestinal bleeding. A controlled randomised trial in 100 critically ill patients. N Engl J Med 1978; 298: 1041-5.","journal-title":"N Engl J Med"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1056\/NEJM198002213020802","article-title":"Antacid versus cimetidine in preventing acute gastrointestinal bleeding","volume":"302","author":"Priebe, H.J.; Skillman, J.S.; Bushnell, L.S.; Long, P.C.; Silen, W.","year":"1980","unstructured":"Priebe HJ, Skillman JS, Bushnell LS, Long PC, Silen W. Antacid versus cimetidine in preventing acute gastrointestinal bleeding. N Engl Med 1980; 302: 426-30.","journal-title":"N Engl Med"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/0002-9343(84)90286-9","article-title":"Prospective evaluation of the risk of upper gastrointestinal bleeding after admission to a medical intensive care unit","volume":"76","author":"Schuster, D.P.; Rowley, H.; Feinstein, S.; McGue, M.K.; Zuckerman, G.R.","year":"1984","unstructured":"Schuster DP, Rowley H, Feinstein S, McGue MK, Zuckerman GR. Prospective evaluation of the risk of upper gastrointestinal bleeding after admission to a medical intensive care unit. Am J Med 1984; 76: 623-30.","journal-title":"Am J Med"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1097\/00005373-197608000-00009","article-title":"Antacid control of complications from acute gastroduodenal disease after burns","volume":"16","author":"JC, Jr, McAlhany; AJ, Czaja; BA, Jr, Pruitt","year":"1976","unstructured":"; 86: 620-6.","journal-title":"J Trauma"},{"issue":"15","key":"ref_17","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/0002-9610(84)90004-7","article-title":"methyl prostaglandin does not prevent gastrointestinal bleeding in seriously ill patients","volume":"15","author":"Skillman, J.J.; Lisbon, A.; Long, P.C.; Silen, W.","year":"1984","unstructured":"McAlhany JC Jr, Czaja AJ, Pruitt BA Jr. Antacid control of complications from acute gastroduodenal disease after burns. J Trauma 1976; 16: 645-8.","journal-title":"Am J Surg"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.27.2.135","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T12:04:08Z","timestamp":1765627448000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.27.2.135"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1986,2]]},"references-count":17,"journal-issue":{"issue":"2","published-online":{"date-parts":[[1986,2,1]]},"published-print":{"date-parts":[[1986,2]]}},"alternative-id":["10.1136\/gut.27.2.135"],"URL":"https:\/\/doi.org\/10.1136\/gut.27.2.135","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1986,2]]}}}