Ranitidine is unable to maintain gastric pH levels above 4 in septic patients

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• 作者：Cristina B. Terzi Coelho ; Desanka Dragosavac ; Joã ; o S. Coelho Neto ; Ciro G. Montes ; Fá ; bio Guerrazzi ; Nelson Adami Andreollo
• 关键词：Stress ulcer prophylaxis ; Septic patients ; Mechanical ventilation ; Gastrointestinal bleeding ; Histamine-2 receptor antagonists ; Proton pump inhibitors
• 刊名：Journal of Critical Care
• 出版年：2009
• 出版时间：December 2009
• 年：2009
• 卷：24
• 期：4
• 页码：627.e7-627.e13
• 全文大小：411 K

文摘

Purpose

The study aimed to evaluate whether ranitidine and pantoprazole are able to maintain gastric pH ≥4 in septic patients.

Materials and methods

Twenty intensive care unit patients from a university teaching hospital with sepsis were included in this study. Ten patients received ranitidine (50 mg as an intermittent bolus 3 times a day) and 10 received pantoprazole (40 mg as an intermittent bolus twice a day). Gastric pH was measured continuously for 48 hours. Endoscopy of the upper digestive tract, gastric biopsy, and investigation for Helicobacter pylori were carried out before and at the end of the study.

Results

pH values ≥4 were maintained for 46.27 % ± 38.21 % and 81.57 % ± 19.65 % of study time in the ranitidine and pantoprazole groups, respectively (P = .04).

Conclusions

Intravenous ranitidine was unable to maintain gastric pH above 4 in septic patients. All cases in the ranitidine group in whom pH remained above 4 had gastric hypotrophy or atrophy. Pantoprazole successfully maintained pH levels above 4.