Guidelines for the prevention and treatment of stress ulcers in critically ill patients (2026)

Stress ulceration is a common complication in critically ill patients, associated with increased mortality risk and prolonged intensive care unit (ICU) stay. In recent years, several large-scale clinical studies on risk factors, prevention, and treatment of stress ulcers have provided new evidence for guideline development. Moreover, the lack of standardized protocols for the prevention and treatment of stress ulcers in clinical practice underscores the urgent need for authoritative guidelines to address current inconsistencies in management strategies. Accordingly, the Chinese Society of Critical Care Medicine established a multidisciplinary expert panel to develop the Guidelines for the prevention and treatment of stress ulcers in critically ill patients (2026). Following the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, the guideline formulation process involved proposing clinical questions, literature retrieval and screening, meta-analysis and evidence synthesis, initial formation of recommendation items, panel reviews, three rounds of remote meetings, four rounds of face-to-face meetings, manuscript revisions, and final approval by the Standing Committee of the Society. The guidelines were finalized in the form of 23 evidence-based recommendations. These guidelines cover key aspects of stress ulcer management, including risk factors, prevention, treatment, and adverse effects of acid-suppressive drugs. The aim is to provide evidence-based guidance for healthcare professionals and promote standardized clinical management of stress ulcers in adult patients.

Published by Zhonghua wei zhong bing ji jiu yi xue, 2026. The guideline itself is at the source linked here.

doi.org/10.3760/cma.j.cn121430-20251203-00583