A Comparison of Sucralfate and Ranitidine for the Prevention of Upper Gastrointestinal Bleeding in Patients Requiring Mechanical Ventilation

Autor:	Deborah Cook, Gordon Guyatt, John Marshall, David Leasa, Hugh Fuller, Richard Hall, Sharon Peters, Frank Rutledge, Lauren Griffith, Allan McLellan, Gordon Wood, Ann Kirby, Martin Tweeddale, Joe Pagliarello, Richard Johnston
Rok vydání:	1998
Předmět:	Mechanical ventilation Gastrointestinal bleeding business.industry medicine.medical_treatment Stress ulcer General Medicine medicine.disease Placebo law.invention Ranitidine Sucralfate Randomized controlled trial law Anesthesia medicine Upper gastrointestinal bleeding business medicine.drug
Zdroj:	New England Journal of Medicine. 338:791-797
ISSN:	1533-4406 0028-4793
DOI:	10.1056/nejm199803193381203
Popis:	Background Critically ill patients who require mechanical ventilation are at increased risk for gastrointestinal bleeding from stress ulcers. There are conflicting data on the effect of histamine H2-receptor antagonists and the cytoprotective agent sucralfate on rates of gastrointestinal bleeding, ventilator-associated pneumonia, and mortality. Methods In a multicenter, randomized, blinded, placebo-controlled trial, we compared sucralfate with the H2-receptor antagonist ranitidine for the prevention of upper gastrointestinal bleeding in 1200 patients who required mechanical ventilation. Patients received either nasogastric sucralfate suspension (1 g every six hours) and an intravenous placebo or intravenous ranitidine (50 mg every eight hours) and a nasogastric placebo. Results The patients in the two groups had similar base-line characteristics. Clinically important gastrointestinal bleeding developed in 10 of 596 (1.7 percent) of the patients receiving ranitidine, as compared with 23 of 604 (3.8 percent...
Databáze:	OpenAIRE
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