Comparison of Acid Neutralizing and Non-Acid Neutralizing Stress Ulcer Prophylasis in Thermally Injured Patients.
ARMY INST OF SURGICAL RESEARCH FORT SAMHOUSTON TX
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We have compared the effectiveness of non-acid neutralizing stress ulcer prophylaxis SUC with sucralfate n 48 with that of acid neutralizing prophylaxis AN utilizing antacids and cimetidine n 48 in the prevention of stress ulcer bleeding and nosocomial pneumonia PN in thermally injured patients. In the subset of intubated patients, the incidence of PN was 17.8 and 42.8 in the AN and SUC groups, respectively p 0.05 despite a similar postburn time of onset of pneumonia. Ten patients in each group died. Three patients in the SUC group developed upper GI bleeding with one requiring gastrectomy. Bacterial colonization of the upper airway occurred in virtually all patients, whereas 83 SUC and 96 AN had colonization of gastric contents. Gram-negative colonization rates for the upper airway were not different 70 whereas 48 of SUC patients compared with 60 of AN patients had gram-negative gastric colonization. In conclusion, SUC therapy was efficacious in the prevention of stress ulcer bleeding but did not alter the rate of bacterial colonization of the airway or gastric contents, and was associated with a higher incidence of nosocomial pneumonia in intubated patients.
- Medicine and Medical Research
- Stress Physiology