Document Detail


Incidence of pneumonia in mechanically ventilated patients treated with sucralfate or cimetidine as prophylaxis for stress bleeding: bacterial colonization of the stomach.
MedLine Citation:
PMID:  1882899     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Retrograde colonization of the oropharynx from the stomach by microaspiration of gastric fluid is a recently recognized phenomenon associated with increased gastric pH that may result in pneumonia during ventilation therapy. In a prospective study we investigated 104 mechanically ventilated patients in the intensive care unit who were receiving sucralfate (n = 49) or cimetidine (n = 55) for stress ulcer prophylaxis. The incidence of pneumonia was 45.5% (25 patients) in the cimetidine group and 26.5% (13 patients) in the sucralfate group (95% confidence interval 0.98 to 6.97; odds ratio 2.61; p = 0.0549). Mortality rates were 18.4% (9 patients) in the sucralfate group versus 25.5% (14 patients) in the cimetidine group (p = 0.48). The mean pH values of gastric aspirates were significantly lower in patients treated with sucralfate than in patients receiving cimetidine (p = 0.044). The number of colony-forming units of Enterobacteriaceae in gastric aspirates was also significantly lower in the sucralfate group (p = 0.0037).
Authors:
I Kappstein; G Schulgen; T Friedrich; P Hellinger; A Benzing; K Geiger; F D Daschner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of medicine     Volume:  91     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  1991 Aug 
Date Detail:
Created Date:  1991-10-03     Completed Date:  1991-10-03     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  125S-131S     Citation Subset:  AIM; IM    
Affiliation:
Department of Hospital Epidemiology, University Hospital Freiburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Bacterial Infections / chemically induced,  complications*,  microbiology
Cimetidine / adverse effects*
Colony Count, Microbial
Cross Infection / epidemiology*,  etiology,  mortality
Female
Gastric Acidity Determination
Germany / epidemiology
Humans
Incidence
Male
Middle Aged
Monitoring, Physiologic
Peptic Ulcer / drug therapy,  etiology,  prevention & control
Pneumonia, Aspiration / epidemiology*,  etiology,  mortality
Prospective Studies
Respiration, Artificial / adverse effects*
Risk Factors
Stomach Diseases / chemically induced,  complications*,  microbiology
Stress, Physiological / complications
Sucralfate / adverse effects*
Trachea / microbiology
Chemical
Reg. No./Substance:
51481-61-9/Cimetidine; 54182-58-0/Sucralfate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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