BACKGROUND: Despite the scanty data, proton pump inhibitors (PPI) are widely used for stress-related mucosal disease (SRMD) prophylaxis. There were few studies using PPI for SRMD prophylaxis but the results were conflicting, most probably due to inadequate sample size. The present meta-analysis aimed to determine the efficacy of PPI, as compared to histamine-2 receptor antagonists (H2RA) in the prevention of SRMD in critically-ill patients. MATERIAL AND METHOD: Meta-analysis of the randomized controlled trials comparing PPI versus H2RA for SRMD prophylaxis was performed. Outcomes of interest were incidences of clinically important gastrointestinal bleeding and nosocomial pneumonia. RESULTS: Three studies involving 569 patients were included in the meta-analysis. The overall incidence of clinically important bleeding was significantly lower in the PPI group (3.5%) as compared to H2RA (8%), odds ratio (OR) 0.42 (95% CI 0.20-0.91). The incidences of nosocomial pneumonia were not different (10.2% versus 10.1%, OR 1.02, 95% CI 0.59-1.75) between the two groups. CONCLUSION: The use of PPI for SRMD prophylaxis was associated with a significantly lower rate of clinically important bleeding than H2RA with similar rates of nosocomial pneumonia.
BACKGROUND: Despite the scanty data, proton pump inhibitors (PPI) are widely used for stress-related mucosal disease (SRMD) prophylaxis. There were few studies using PPI for SRMD prophylaxis but the results were conflicting, most probably due to inadequate sample size. The present meta-analysis aimed to determine the efficacy of PPI, as compared to histamine-2 receptor antagonists (H2RA) in the prevention of SRMD in critically-illpatients. MATERIAL AND METHOD: Meta-analysis of the randomized controlled trials comparing PPI versus H2RA for SRMD prophylaxis was performed. Outcomes of interest were incidences of clinically important gastrointestinal bleeding and nosocomial pneumonia. RESULTS: Three studies involving 569 patients were included in the meta-analysis. The overall incidence of clinically important bleeding was significantly lower in the PPI group (3.5%) as compared to H2RA (8%), odds ratio (OR) 0.42 (95% CI 0.20-0.91). The incidences of nosocomial pneumonia were not different (10.2% versus 10.1%, OR 1.02, 95% CI 0.59-1.75) between the two groups. CONCLUSION: The use of PPI for SRMD prophylaxis was associated with a significantly lower rate of clinically important bleeding than H2RA with similar rates of nosocomial pneumonia.
Authors: Craig M Lilly; Mohammad Aljawadi; Omar Badawi; Ebere Onukwugha; Sarah E Tom; Laurence S Magder; Ilene Harris Journal: Chest Date: 2018-05-30 Impact factor: 9.410
Authors: Marija Barbateskovic; Søren Marker; Anders Granholm; Carl Thomas Anthon; Mette Krag; Janus Christian Jakobsen; Anders Perner; Jørn Wetterslev; Morten Hylander Møller Journal: Intensive Care Med Date: 2019-01-24 Impact factor: 17.440
Authors: R P Dellinger; Mitchell M Levy; Andrew Rhodes; Djillali Annane; Herwig Gerlach; Steven M Opal; Jonathan E Sevransky; Charles L Sprung; Ivor S Douglas; Roman Jaeschke; Tiffany M Osborn; Mark E Nunnally; Sean R Townsend; Konrad Reinhart; Ruth M Kleinpell; Derek C Angus; Clifford S Deutschman; Flavia R Machado; Gordon D Rubenfeld; Steven Webb; Richard J Beale; Jean-Louis Vincent; Rui Moreno Journal: Intensive Care Med Date: 2013-01-30 Impact factor: 17.440