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Crit Care Med. 1994 Dec;22(12):1949-54.

Prospective endoscopic study of stress erosions and ulcers in critically ill adult patients treated with either sucralfate or placebo.

Author information

1
Critical Care Unit, Manchester Royal Infirmary, UK.

Abstract

OBJECTIVE:

To compare the frequency of stress erosions and ulcers in critically ill adult patients treated with either sucralfate or placebo.

DESIGN:

Prospective, randomized study.

SETTING:

Intensive care unit in a university hospital.

PATIENTS:

Twenty-six adult patients. All patients were mechanically ventilated and were at risk of developing stress ulceration.

INTERVENTIONS:

Patients were randomized to receive either sucralfate (2 g every 8 hrs) (group 1) via the nasogastric tube (flushed with 10 mL of sterile water) or 20 mL of sterile water every 8 hrs (group 2) via the nasogastric tube.

MEASUREMENTS AND MAIN RESULTS:

At the time of intensive care unit admission, the frequency of stress (acute) erosions (as assessed with the endoscope) was 21.7%. No ulcers were detected. By day 3, the frequency had increased to 37.5% in group 1 and 88.9% in group 2. Mucosal deterioration was more likely in the patients treated with placebo (water) (p < .05). In total, seven patients developed acute ulceration in group 2 compared with only one patient in group 1 (p < .05). The frequency of gastric colonization with aerobic Gram-negative bacilli was 25.6% in group 1 and 28.6% in group 2. Only one retrograde nosocomial pneumonia developed (group 1).

CONCLUSION:

Based on our findings, we strongly recommend the adoption of sucralfate as opposed to no prophylaxis in the prevention of acute upper gastrointestinal ulceration.

PMID:
7988131
[Indexed for MEDLINE]

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