Which of the following risk factors have been shown to increase significantly the incidence of gastrointestinal bleeding from stress gastritis in intensive care unit (ICU) patients?

B. Respiratory failure.

C. Coagulopathy.

DISCUSSION: Prophylactic measures such as H 2-receptor antagonists and antacid titration effectively reduce the incidence of gastrointestinal bleeding; however, prophylaxis against stress gastritis is expensive and may have adverse effects. Therefore, it should be used selectively in patients with high risk factors. In a prospective multicenter study in which 10 potential risk factors were evaluated for stress gastritis bleeding in ICU patients, respiratory failure and coagulopathy are two independent risk factors for clinically significant bleeding. Therefore, a strong recommendation for prophylaxis of stress gastritis can be made for ICU patients who have either respiratory failure or coagulopathy.