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A 59-year-old with septic shock and ARDS has platelets 32,000 and stress-dose hydrocortisone. He has no GI bleeding, is mechanically ventilated, and receives enteral nutrition. Which stress ulcer plan is best?
Use pharmacologic prophylaxis only if bleeding risk outweighs pneumonia and C difficile risks
Give high-dose PPI to every ICU patient
Avoid prophylaxis because ventilation is never a risk factor
Use sucralfate because it prevents VAP better than acid suppression
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