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Titolo:
Intravenous omeprazole in critically ill patients: A randomized, crossoverstudy comparing 40 with 80 mg plus 8 mg/hour on intragastric pH
Autore:
Laterre, PF; Horsmans, Y;
Indirizzi:
Clin Univ St Luc, ICU, Dept Crit Care Med, B-1200 Brussels, Belgium Clin Univ St Luc Brussels Belgium B-1200 e Med, B-1200 Brussels, Belgium Clin Univ St Luc, Dept Gastroenterol, B-1200 Brussels, Belgium Clin Univ St Luc Brussels Belgium B-1200 terol, B-1200 Brussels, Belgium
Titolo Testata:
CRITICAL CARE MEDICINE
fascicolo: 10, volume: 29, anno: 2001,
pagine: 1931 - 1935
SICI:
0090-3493(200110)29:10<1931:IOICIP>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
PROPHYLAXIS; RANITIDINE; THERAPY; TRIAL;
Keywords:
omeprazole; intravenous; bolus; continuous infusion; intragastric pH; critically ill; stress ulcer; risk factors;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
16
Recensione:
Indirizzi per estratti:
Indirizzo: Laterre, PF Clin Univ St Luc, ICU, Dept Crit Care Med, Ave Hippocrate 10, B-1200 Brussels, Belgium Clin Univ St Luc Ave Hippocrate 10 Brussels Belgium B-1200 um
Citazione:
P.F. Laterre e Y. Horsmans, "Intravenous omeprazole in critically ill patients: A randomized, crossoverstudy comparing 40 with 80 mg plus 8 mg/hour on intragastric pH", CRIT CARE M, 29(10), 2001, pp. 1931-1935

Abstract

Objective. To compare intravenous omeprazole 40-mg single dose with 8 mg/hr after an 80-mg bolus injection on 24-hr intragastric pH in intensive careunit (ICU) ventilated patients. Design. Prospective, randomized crossover study. Setting. A 42-bed medicosurgical ICU in a university hospitalPatients. Medicosurgical ventilated patients at risk of gastrointestinal bleeding. Interventions. After baseline determination of intragastric pH, patients were randomly allocated to have a 40-mg iv omeprazole bolus injection (arm I) or 80 mg bolus, followed by 8 mg/hr continuous infusion for 24 hrs (arm II). After a 24-hr washout period, the opposite regimen was given in a crossover design. Intragastric pH was determined at regular intervals during thetreatment period. Results: In ten patients completing the protocol, the intragastric pH was similar for the two regimens for the first 12 hrs. The area under the pH curve was 5.51 +/- 0.48 for arm I compared with 6.02 +/- 0.33 for arm II (NS). Time to reach a pH of 4 or 6 was not significantly different for the two regimens. Time spent with a pH greater than 4 and 6 for the first 12 hrs was 10.11 +/- 1.14 and 8.31 +/- 1.16 hrs vs. 10.11 +/- 0.75 and 7.43 +/- 1.19hrs for arm I and arm II, respectively (NS). When the first 24 hrs are considered, the area under the pH curve was 5.17 +/- 0.49 for arm I vs. 6.36 +/- 0.25 for arm II (p < .05). Time spent with a pH greater than 4 and 6 was17.2 +/- 2.4 hrs and 12.63 +/- 2.22 vs. 23 +/- 0.41 and 19.48 +/- 1.63 in arm I and arm II, respectively (p < .05 and .01). An intragastric pH above 6 for all determinations was only observed in arm II. Conclusions. In critically ill patients, intravenous omeprazole 40 mg single dose is as effective as 8 mg/hr after an 80-mg bolus injection on mean intragastric pH, time spent with a pH greater than 4 and 6, but only for thefirst 12 hrs. If an intragastric pH greater than 6 has to be maintained for 24 hrs in all patients, an 80-mg bolus followed by 8 mg/hr iv omeprazole is to be given. Our data suggest that in several critically ill patients, asingle 40-mg iv omeprazole bolus injection may be able to achieve stress ulcer prophylaxis and that 40 mg twice daily should be compared with 8 mg/hrafter an 80-mg bolus injection in bleeding ulcers.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 09:35:33