Document Detail


Preventing postoperative acute bleeding of the upper part of the gastrointestinal tract.
MedLine Citation:
PMID:  2237719     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Two hundred and ninety-eight critically ill patients at risk for the development of postoperative stress ulcers and bleeding were randomized into three groups. The first group comprised 85 patients who received meciadanol, a new bioflavonoid, 500 milligrams every six hours through a nasograstric tube; the second group comprised 100 patients who received sucralfate (crushed tablets), 1,000 milligrams every six hours through a nasogastric tube, and the third group comprised 113 patients who received an antacid (Maalox [magnesium aluminum hydroxide gel]) through a nasogastric tube at an initial dose of 15 milliliters every hour. The gastric pH was measured hourly and titrated to a pH greater than or equal to 4.0 in patients in the group receiving the antacid. The gastric pH was measured every two hours in the other two groups. Bleeding in the upper part of the gastrointestinal tract was determined visually (frank blood in gastric contents) or by guaiac testing. Bleeding occurred in seven patients receiving meciadanol, nine receiving sucralfate and six receiving the antacid. The difference in rates of bleeding was not statistically significant. Correlation between the severity of illness index and the development of bleeding was poor, at least in the low and intermediate index range. In contrast, there was a strong correlation between the age of the patient and the development of bleeding. Only one patient younger than 50 years had bleeding develop. Apparently, meciadanol exerts its action by a mechanism other than pH control. It may, therefore, fill an important gap in the ability to prevent postoperative stress ulcers and bleeding.
Authors:
M E Kitler; A Hays; J P Enterline; M Allo; G D Zuidema
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Surgery, gynecology & obstetrics     Volume:  171     ISSN:  0039-6087     ISO Abbreviation:  Surg Gynecol Obstet     Publication Date:  1990 Nov 
Date Detail:
Created Date:  1990-12-04     Completed Date:  1990-12-04     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0101370     Medline TA:  Surg Gynecol Obstet     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  366-72     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Aluminum Hydroxide / administration & dosage,  therapeutic use
Anti-Ulcer Agents / administration & dosage,  therapeutic use*
Catechin / administration & dosage,  analogs & derivatives,  therapeutic use
Drug Combinations
Female
Gastric Acidity Determination
Humans
Magnesium Hydroxide / administration & dosage,  therapeutic use
Male
Middle Aged
Peptic Ulcer / etiology,  prevention & control*
Peptic Ulcer Hemorrhage / etiology,  prevention & control*
Postoperative Complications / prevention & control*
Prospective Studies
Stress, Physiological / complications
Sucralfate / administration & dosage,  therapeutic use
Chemical
Reg. No./Substance:
0/Anti-Ulcer Agents; 0/Drug Combinations; 1309-42-8/Magnesium Hydroxide; 154-23-4/Catechin; 21645-51-2/Aluminum Hydroxide; 37317-08-1/aluminum hydroxide, magnesium hydroxide, drug combination; 54182-58-0/Sucralfate; 87367-19-9/3-O-methylcatechin

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


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