Stress ulcer prophylaxis is an important part of the medical management in those patients at risk of gastrointestinal bleeding such as patients receiving mechanical ventilation, steroid therapy, with coa gulation abnormalities or history of gastrodudenal ulcer12.
Early EN (within 48 hours of admission) has been proved to be an independent protective factor for gas trointestinal bleeding in patients who receive mechani cal ventilation20'21.
In order that with every mechanically ventilated pa tient who is not receiving EN it should be evaluated to start it, if this is not possible stress ulcer prophylaxis must start or be continued.