Histamine 2 receptor antagonists vs intravenous proton pump inhibitors in a pediatric intensive care unit: a comparison of gastric pH

Journal of Critical Care
Nancy M TofilMargaret K Winkler

Abstract

The aim of this study was to assess gastric pH in critically ill pediatric patients receiving intravenous stress ulcer medication. A prospective study was done in 48 patients with a gastric tube in place who were receiving either ranitidine or a proton pump inhibitor and no enteral nutrition. Daily peak and trough gastric pHs were measured. The median age was 7 years 5 months (range, 1 month to 19 years), the median weight was 31 kg (range, 3-130 kg), and the median pediatric risk of mortality 2 (PRISM2) score was 12.5 (range, 0-31). All patients were intubated and 8 received dialysis. The average trough pH was 4.4 +/- 1.6 in the ranitidine group, 4.9 +/- 1.8 in the once daily proton pump inhibitor group, and 5.0 +/- 1.2 in the twice daily proton pump inhibitor group (P = .16). The average peak pH was 5.3 +/- 1.8 in the ranitidine group, 5.9 +/- 1.6 in the once daily proton pump inhibitor group, and 6.0 +/- 1.0 in the twice daily proton pump inhibitor group (P = .06). Three (10%) of 28 trough pH measurements in the twice daily proton pump inhibitor group were more acidic than 4 vs 24 (40%) of 60 in the ranitidine group, and 22 (40%) of 56 in the once daily proton pump inhibitor group (P = .02). One (4%) of 27 peak pH measuremen...Continue Reading

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Citations

Dec 3, 2013·Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi·Chih-Hung ChenChang-Phone Fung
Sep 28, 2015·The Journal of Pediatrics·Christopher M Stark, Cade M Nylund
Dec 3, 2010·Allergy·I Pali-Schöll, E Jensen-Jarolim
Apr 23, 2015·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Andrew T CostarinoJames P Guevara
Sep 7, 2013·Pediatric Gastroenterology, Hepatology & Nutrition·Kie Young Park, Soo Hee Chang
Jun 5, 2018·The Cochrane Database of Systematic Reviews·Ingrid ToewsJoerg J Meerpohl
Nov 3, 2017·American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses·Norma A MethenyKathleen L Meert
Sep 4, 2015·American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses·Kathleen L MeertNorma A Metheny
Jan 10, 2020·BioMed Research International·Michał WicińskiKatarzyna Pawlak-Osińska

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