Evaluation of Ventilator-Associated Pneumonia According to Stress Related Mucosal Disease Prophylaxis Regimen in the Intensive Care Unit
Background: Ventilator-associated pneumonia (VAP) increases the cost of intensive care unit (ICU) treatment and the chance of mortality. Due to the increasing use of proton pump inhibitors (PPI) and H2 receptor inhibitors for stress ulcer prophylaxis, the purpose of the study was to investigate the...
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doaj-1d1c681635634f49baa841abc955b5102020-11-25T03:59:18ZengTehran University of Medical SciencesArchives of Anesthesia and Critical Care2423-58492015-11-0114Evaluation of Ventilator-Associated Pneumonia According to Stress Related Mucosal Disease Prophylaxis Regimen in the Intensive Care UnitMohammad Reza Hajiesmaeili0Omid Moradi Moghadam1Alireza Sedaghat2Mohammad Niakan3Shahram Seifi4Farshid Rahimi Bashar5Amir Vahedian Azimi6Hosna Forooghirad7Davood Yadegarynia8Mohammad Fathi9Department of Anesthesiology and Critical Care, Shahid Beheshti University of Medical Science, Tehran, IranDepartment of Anesthesiology and Critical Care, Iran University of Medical Science, Tehran, Iran3Department of Anesthesiology and Critical Care, Mashhad University of Medical Science, Mashhad, Iran.Department of Anesthesiology and Critical Care, Iran University of Medical Science, Tehran, IranDepartment of Anesthesiology and Critical Care, Babol University of Medical Science, Babol, IranDepartment of Anesthesiology and Critical Care, Hamadan University of Medical Science, Hamadan, IranTrauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, IranInfectious Disease and Tropical Medicine Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran.Infectious Disease and Tropical Medicine Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran.Department of Anesthesiology and Critical Care, Shahid Beheshti University of Medical Science, Tehran, Iran Background: Ventilator-associated pneumonia (VAP) increases the cost of intensive care unit (ICU) treatment and the chance of mortality. Due to the increasing use of proton pump inhibitors (PPI) and H2 receptor inhibitors for stress ulcer prophylaxis, the purpose of the study was to investigate the differences of VAP in two groups of patients receiving PPI or H2 blocker. Methods: In the retrospective cross sectional study, from September 2011 to September 2012, 43 patients who had positive pulmonary cultures (PC) were studied. These patients had a clinical pulmonary infection score (CPIS) ≥6 for more than 48 hours after receiving stress related mucosal diseases prophylaxis (SRMD). Patients whose SRMD prophylaxis was changed within 72 hours before obtaining the PC samples were excluded. Patients were divided into two groups. One group received pantoprazole (20 cases) and the other group received ranitidine (23 cases). Between the groups, age, sex, APACHE II score, predicted mortality, type of used SRMD prophylaxis drug, duration of prophylaxis prior to PC sampling, interval time between ICU admission and VAP manifestation, the type of bacterial causes of VAP, gastrointestinal bleeding, ICU length of stay and actual mortality were compared. Results: The APACHE II score and predicted mortality were higher in the pantoprazole group (P=0.173, 0.167). We found that 30% of the ranitidine group suffered from upper GI bleeding. In the pantoprazole group, 21.74% suffered from upper GI bleeding (P<0.001). Patients receiving ranitidine had a higher mortality rate and a worse prognosis (P< 0.001). Conclusion: Although there were more critically ill patients with a higher predicted mortality in the pantoprazole group, the ranitidine recipients turned out to have a higher mortality rate. https://aacc.tums.ac.ir/index.php/aacc/article/view/38Ventilator-associated pneumoniastress related mucosal diseasesprophylaxisintensive care unit |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mohammad Reza Hajiesmaeili Omid Moradi Moghadam Alireza Sedaghat Mohammad Niakan Shahram Seifi Farshid Rahimi Bashar Amir Vahedian Azimi Hosna Forooghirad Davood Yadegarynia Mohammad Fathi |
spellingShingle |
Mohammad Reza Hajiesmaeili Omid Moradi Moghadam Alireza Sedaghat Mohammad Niakan Shahram Seifi Farshid Rahimi Bashar Amir Vahedian Azimi Hosna Forooghirad Davood Yadegarynia Mohammad Fathi Evaluation of Ventilator-Associated Pneumonia According to Stress Related Mucosal Disease Prophylaxis Regimen in the Intensive Care Unit Archives of Anesthesia and Critical Care Ventilator-associated pneumonia stress related mucosal diseases prophylaxis intensive care unit |
author_facet |
Mohammad Reza Hajiesmaeili Omid Moradi Moghadam Alireza Sedaghat Mohammad Niakan Shahram Seifi Farshid Rahimi Bashar Amir Vahedian Azimi Hosna Forooghirad Davood Yadegarynia Mohammad Fathi |
author_sort |
Mohammad Reza Hajiesmaeili |
title |
Evaluation of Ventilator-Associated Pneumonia According to Stress Related Mucosal Disease Prophylaxis Regimen in the Intensive Care Unit |
title_short |
Evaluation of Ventilator-Associated Pneumonia According to Stress Related Mucosal Disease Prophylaxis Regimen in the Intensive Care Unit |
title_full |
Evaluation of Ventilator-Associated Pneumonia According to Stress Related Mucosal Disease Prophylaxis Regimen in the Intensive Care Unit |
title_fullStr |
Evaluation of Ventilator-Associated Pneumonia According to Stress Related Mucosal Disease Prophylaxis Regimen in the Intensive Care Unit |
title_full_unstemmed |
Evaluation of Ventilator-Associated Pneumonia According to Stress Related Mucosal Disease Prophylaxis Regimen in the Intensive Care Unit |
title_sort |
evaluation of ventilator-associated pneumonia according to stress related mucosal disease prophylaxis regimen in the intensive care unit |
publisher |
Tehran University of Medical Sciences |
series |
Archives of Anesthesia and Critical Care |
issn |
2423-5849 |
publishDate |
2015-11-01 |
description |
Background: Ventilator-associated pneumonia (VAP) increases the cost of intensive care unit (ICU) treatment and the chance of mortality. Due to the increasing use of proton pump inhibitors (PPI) and H2 receptor inhibitors for stress ulcer prophylaxis, the purpose of the study was to investigate the differences of VAP in two groups of patients receiving PPI or H2 blocker.
Methods: In the retrospective cross sectional study, from September 2011 to September 2012, 43 patients who had positive pulmonary cultures (PC) were studied. These patients had a clinical pulmonary infection score (CPIS) ≥6 for more than 48 hours after receiving stress related mucosal diseases prophylaxis (SRMD). Patients whose SRMD prophylaxis was changed within 72 hours before obtaining the PC samples were excluded. Patients were divided into two groups. One group received pantoprazole (20 cases) and the other group received ranitidine (23 cases). Between the groups, age, sex, APACHE II score, predicted mortality, type of used SRMD prophylaxis drug, duration of prophylaxis prior to PC sampling, interval time between ICU admission and VAP manifestation, the type of bacterial causes of VAP, gastrointestinal bleeding, ICU length of stay and actual mortality were compared.
Results: The APACHE II score and predicted mortality were higher in the pantoprazole group (P=0.173, 0.167). We found that 30% of the ranitidine group suffered from upper GI bleeding. In the pantoprazole group, 21.74% suffered from upper GI bleeding (P<0.001). Patients receiving ranitidine had a higher mortality rate and a worse prognosis (P< 0.001).
Conclusion: Although there were more critically ill patients with a higher predicted mortality in the pantoprazole group, the ranitidine recipients turned out to have a higher mortality rate.
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topic |
Ventilator-associated pneumonia stress related mucosal diseases prophylaxis intensive care unit |
url |
https://aacc.tums.ac.ir/index.php/aacc/article/view/38 |
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