A Comparative Study between Proton Pump Inhibitor (Pantoprazol) and Histamine Receptor Antagonist (Ranitidine) for Prevention of Stress Ulcer in Mechanically Ventilated Patients

Abstract

tress ulceration, So-called 'stress-related mucosal damage' (SRMD) is the broad term used to describe the spectrum of pathology attributed to the acute, erosive, inflammatory insult to the upper gastrointestinal tract associated with critical illness. Critically ill patients are at increased risk of developing SRMD and subsequent stress-ulcer bleeding as a result of both underlying disease and therapeutic intervention (Peura, 1986). The incidence of gastrointestinal bleeding among mechanically ventilated patients has been declining over the past 30 years from 15–50% to 2-25% due to stress ulcer prophylaxis measures (Buenedgens et al., 2016). Most commonly used drugs in the prophylaxis against stress related mucosal disease are proton pump inhibitors and histamine-2receptor antagonists (Clark et al., 2009). Our study was done to compare between the efficacy of PPIs and H2RAson prevention of stress ulcer in critically ill mechanically ventilated patients. The study was done over 102 critically ill patients who were admitted to the ICU. The measured outcomes were the gastric pH, gastric juice volume, and the incidence of GI bleeding, as a primary outcomes. While the incidence of nosocomial pneumonia and clostridium difficile infection were secondary outcomes for these study.