PMID- 21725797
OWN - NLM
STAT- MEDLINE
DCOM- 20110927
LR  - 20110704
IS  - 0065-1419 (Print)
IS  - 0065-1419 (Linking)
VI  - 111
DP  - 2011
TI  - Proton pump inhibitor prophylaxis increases the risk of nosocomial pneumonia in 
      patients with an intracerebral hemorrhagic stroke.
PG  - 435-9
LID - 10.1007/978-3-7091-0693-8_75 [doi]
AB  - BACKGROUND: Stress-related mucosal damage is an erosive process of the gastric 
      lining resulting from abnormally high physiologic demands. To avoid the morbidity 
      and mortality associated with significant bleeding from the damage, prophylaxis 
      with an acid suppression medication is given. This is especially common in stroke 
      victims. Recent studies have suggested a link between acid suppression therapy 
      and nosocomial pneumonia, specifically implicating proton pump inhibitors (PPI), 
      a potent acid suppression medication, as the culprit. In this retrospective 
      study, we reviewed the medical records of admitted intracerebral hemorrhage (ICH) 
      patients and determined if there is a link between PPI prophylaxis and nosocomial 
      pneumonia in our ICH population. MATERIALS AND METHODS: Medical records of 200 
      ICH patients admitted to the First Affiliated Hospital of Chongqing Medical 
      University were reviewed from January 1, 2008 to October 31, 2009. PPIs were the 
      only accepted form of acid suppression therapy. In all, 95 patients were given 
      PPI prophylaxis, whereas 105 patients did not receive any form of acid 
      suppression. RESULTS: The unadjusted incidence rate of pneumonia in the PPI 
      prophylactic group was 23.2%, and 10.5% in patients not having received 
      prophylaxis. Additionally, patients treated with PPI prophylaxis were more likely 
      to be critically ill, defined by an increase in conscious disturbance and 
      dependency on mechanical ventilation and/or a nasogastric tube. CONCLUSION: The 
      use of a PPI as a prophylactic treatment against stress-related mucosal damage 
      was associated with a higher occurrence of nosocomial pneumonia in our ICH 
      population. This study suggests the need for further research investigating the 
      use of PPI prophylaxis in ICH patients and the possibility of using alternate 
      acid suppression therapeutic modalities.
FAU - Ran, Li
AU  - Ran L
AD  - First Affiliated Hospital, Chongqing Medical University, Chongqing, China.
FAU - Khatibi, Nikan H
AU  - Khatibi NH
FAU - Qin, Xinyue
AU  - Qin X
FAU - Zhang, John H
AU  - Zhang JH
LA  - eng
GR  - NS053407/NS/NINDS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - Austria
TA  - Acta Neurochir Suppl
JT  - Acta neurochirurgica. Supplement
JID - 100962752
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cerebral Hemorrhage/*drug therapy/etiology
MH  - Cohort Studies
MH  - Cross Infection/*chemically induced/complications
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pneumonia/*chemically induced/complications
MH  - Proton Pump Inhibitors/*adverse effects
MH  - Retrospective Studies
MH  - Statistics, Nonparametric
MH  - Stroke/complications
EDAT- 2011/07/05 06:00
MHDA- 2011/09/29 06:00
CRDT- 2011/07/05 06:00
PHST- 2011/07/05 06:00 [entrez]
PHST- 2011/07/05 06:00 [pubmed]
PHST- 2011/09/29 06:00 [medline]
AID - 10.1007/978-3-7091-0693-8_75 [doi]
PST - ppublish
SO  - Acta Neurochir Suppl. 2011;111:435-9. doi: 10.1007/978-3-7091-0693-8_75.