Chien-Chu Lin1, Yeong-Long Hsu2, Chen-Shuan Chung3, Tzong-Hsi Lee4. 1. Division of Gastroenterology and Hepatology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan. 2. Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Division of Thoracic Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan. 3. Division of Gastroenterology and Hepatology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan. 4. Division of Gastroenterology and Hepatology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan. Electronic address: thleekimo@yahoo.com.tw.
Abstract
BACKGROUND/ PURPOSE: No data has been available on prophylaxis for stress ulcer development during the process of weaning patients off mechanical ventilators. We conducted a randomized study to evaluate the efficacy of stress ulcer prophylaxis with lansoprazole OD in patients being weaned from mechanical ventilators. METHODS:A total of 120 patients were randomly allocated into two groups using blocked randomization, with 60 patients in each group. Group A was the treatment group, receiving lansoprazole OD 30 mg from a nasogastric tube for 14 days, while Group B, the control group, received no proton pump inhibitors or other medications for treating peptic ulcers. The primary end point of our study was apparent upper gastrointestinal bleeding within 2 weeks of enrollment. RESULTS:Apparent upper gastrointestinal bleeding occurred in zero patients and five patients in Groups A and B, respectively (Group A: 0% vs. Group B: 8.3%, p = 0.057). There was no significant difference between the two groups in ventilator-associated pneumonia (Group A: 6.7% vs. Group B: 10.0%, p = 0.509) and 30-day survival rates (Group A: 96.7% vs. Group B: 100%, p = 0.496). CONCLUSION: Stress ulcer prophylaxis with lansoprazole in patients being weaned from mechanical ventilators led to a lower but not statistically significant incidence of apparent upper gastrointestinal bleeding. There was no significant increase of incidence of ventilator-associated pneumonia in the prophylaxis group. Further larger scale studies are needed to clarify the benefit of stress ulcer prophylaxis in such patients.
RCT Entities:
BACKGROUND/ PURPOSE: No data has been available on prophylaxis for stress ulcer development during the process of weaning patients off mechanical ventilators. We conducted a randomized study to evaluate the efficacy of stress ulcer prophylaxis with lansoprazole OD in patients being weaned from mechanical ventilators. METHODS: A total of 120 patients were randomly allocated into two groups using blocked randomization, with 60 patients in each group. Group A was the treatment group, receiving lansoprazole OD 30 mg from a nasogastric tube for 14 days, while Group B, the control group, received no proton pump inhibitors or other medications for treating peptic ulcers. The primary end point of our study was apparent upper gastrointestinal bleeding within 2 weeks of enrollment. RESULTS: Apparent upper gastrointestinal bleeding occurred in zero patients and five patients in Groups A and B, respectively (Group A: 0% vs. Group B: 8.3%, p = 0.057). There was no significant difference between the two groups in ventilator-associated pneumonia (Group A: 6.7% vs. Group B: 10.0%, p = 0.509) and 30-day survival rates (Group A: 96.7% vs. Group B: 100%, p = 0.496). CONCLUSION:Stress ulcer prophylaxis with lansoprazole in patients being weaned from mechanical ventilators led to a lower but not statistically significant incidence of apparent upper gastrointestinal bleeding. There was no significant increase of incidence of ventilator-associated pneumonia in the prophylaxis group. Further larger scale studies are needed to clarify the benefit of stress ulcer prophylaxis in such patients.
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: Søren Marker; Anders Perner; Jørn Wetterslev; Marija Barbateskovic; Janus Christian Jakobsen; Mette Krag; Anders Granholm; Carl Thomas Anthon; Morten Hylander Møller Journal: Syst Rev Date: 2017-06-24
Authors: Ingrid Toews; Aneesh Thomas George; John V Peter; Richard Kirubakaran; Luís Eduardo S Fontes; Jabez Paul Barnabas Ezekiel; Joerg J Meerpohl Journal: Cochrane Database Syst Rev Date: 2018-06-04