PMID- 19459523
OWN - NLM
STAT- MEDLINE
DCOM- 20090623
LR  - 20090522
IS  - 0125-2208 (Print)
IS  - 0125-2208 (Linking)
VI  - 92
IP  - 5
DP  - 2009 May
TI  - Proton pump inhibitors for the prevention of stress-related mucosal disease in 
      critically-ill patients: a meta-analysis.
PG  - 632-7
AB  - BACKGROUND: Despite the scanty data, proton pump inhibitors (PPI) are widely used 
      for stress-related mucosal disease (SRMD) prophylaxis. There were few studies 
      using PPI for SRMD prophylaxis but the results were conflicting, most probably 
      due to inadequate sample size. The present meta-analysis aimed to determine the 
      efficacy of PPI, as compared to histamine-2 receptor antagonists (H2RA) in the 
      prevention of SRMD in critically-ill patients. MATERIAL AND METHOD: Meta-analysis 
      of the randomized controlled trials comparing PPI versus H2RA for SRMD 
      prophylaxis was performed. Outcomes of interest were incidences of clinically 
      important gastrointestinal bleeding and nosocomial pneumonia. RESULTS: Three 
      studies involving 569 patients were included in the meta-analysis. The overall 
      incidence of clinically important bleeding was significantly lower in the PPI 
      group (3.5%) as compared to H2RA (8%), odds ratio (OR) 0.42 (95% CI 0.20-0.91). 
      The incidences of nosocomial pneumonia were not different (10.2% versus 10.1%, OR 
      1.02, 95% CI 0.59-1.75) between the two groups. CONCLUSION: The use of PPI for 
      SRMD prophylaxis was associated with a significantly lower rate of clinically 
      important bleeding than H2RA with similar rates of nosocomial pneumonia.
FAU - Pongprasobchai, Supot
AU  - Pongprasobchai S
AD  - Division of Gastroenterology, Department of Internal Medicine, Siriraj Hospital, 
      Bangkok, Thailand. tespb@mahidol.ac.th
FAU - Kridkratoke, Samruay
AU  - Kridkratoke S
FAU - Nopmaneejumruslers, Cherdchai
AU  - Nopmaneejumruslers C
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PL  - Thailand
TA  - J Med Assoc Thai
JT  - Journal of the Medical Association of Thailand = Chotmaihet thangphaet
JID - 7507216
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Histamine H2 Antagonists)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Anti-Ulcer Agents/*adverse effects
MH  - Confidence Intervals
MH  - Critical Illness
MH  - Cross Infection/etiology
MH  - Gastric Mucosa
MH  - Histamine H2 Antagonists/*adverse effects
MH  - Humans
MH  - Odds Ratio
MH  - Peptic Ulcer/*prevention & control
MH  - Pneumonia/etiology
MH  - Proton Pump Inhibitors/*adverse effects
MH  - Randomized Controlled Trials as Topic
MH  - Stomach Diseases/etiology
MH  - Stress, Physiological/*drug effects
MH  - Treatment Outcome
EDAT- 2009/05/23 09:00
MHDA- 2009/06/24 09:00
CRDT- 2009/05/23 09:00
PHST- 2009/05/23 09:00 [entrez]
PHST- 2009/05/23 09:00 [pubmed]
PHST- 2009/06/24 09:00 [medline]
PST - ppublish
SO  - J Med Assoc Thai. 2009 May;92(5):632-7.