Paper Information

Journal:   INTERNATIONAL JOURNAL OF PEDIATRICS   November 2016 , Volume 4 , Number 11 (35); Page(s) 3917 To 3924.
 
Paper: 

Effect of Gastric Acid Suppressant Prophylaxis on Incidence of Gastrointestinal Bleeding in Pediatric Intensive Care Unit

 
 
Author(s):  Abdollahi Tahoora, SABZEVARI ALIREZA, KHAKSHOUR ALI, ATAEE NAKHAEI ALIREZA, SEZAVAR MAJID, Etezadie Toktam, KIANIFAR HAMIDREZA, JAFARI SEYED ALI, KIANI MOHAMMAD ALI*
 
* Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
 
Abstract: 
Background: Critically ill children admitted to pediatric intensive care unit (PICU) are at increased risk of gastrointestinal bleeding due to stress related mucosal injury. Reducing gastric acid by acid suppressant medication is the accepted prophylaxis treatment, but there is not any definitive guideline for using prophylaxis in PICU patients. The present study aimed to assess the effect of Proton Pump Inhibitor (PPI) and H2 Blocker (H2B) prophylaxis on gastrointestinal bleeding in admitted patients of PICU, Mashhad-Iran. Materials and Methods: In this study, 100 patients admitted in PICU divided into two equal groups on the first day of admission. They received ranitidine or pantoprazole as prophylaxis of stress ulcer. Those patients who had history of gastrointestinal bleeding or coagulation disorder were excluded. 100 PICU patients who had not received prophylaxis during last 6 months retrospectively evaluated as control of the study. Data were collected as demographic characteristics, admission reason, definitive diagnosis, receiving corticosteroid and mechanical ventilation in each patient. Gastrointestinal bleeding (hematemesis, coffee ground aspirate, and melena) and clinically significant gastrointestinal bleeding were daily monitored. Data analyzed through descriptive statistical tests, Chi-square, logistic regression, t-test and using SPSS-16 software. Results: Among 204 patients (control group=105 and case group=99), incidence of gastrointestinal bleeding (GB) was 13. 2% in which 6. 9% of cases presented with clinically significant gastrointestinal bleeding (CSGB). Loss of consciousness and respiratory distress were the main reason of admission. There was no significant differences between the incidence of (GB) and (CSGB) in experimental and control groups (P>0. 05) as well as ranitidine and pantoprazole prophylaxis (P>0. 05). Significant risk factors of (GB) were mechanical ventilation and loss of consciousness and corticosteroid therapy. Conclusion: There is ambiguity about probable benefits of gastrointestinal bleeding prophylaxis in critically ill children. We proposed that prophylaxis should prescribe in patients with two or more risk factors of gastrointestinal bleeding.
 
Keyword(s): Children,Gastrointestinal bleeding prophylaxis,Pantoprazole,Ranitidine
 
References: 
  • ندارد
 
  pdf-File tarjomyar Yearly Visit 48
 
Latest on Blog
Enter SID Blog