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| The effects of sucralfate and proton pump inhibitors on ventilator-associated pneumonia of patients with mechanical ventilation in Intensive Care Unit |
| Sheng Ying, Wang Shu-yun, Wang Jing-en, Shi Qi-fang, Xie Xiao-hong, Gao Bo, Zhu Nian, Cai Jin-fang |
| epartment of Intensive Care Unit, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai 201399, China |
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Abstract Objective: To investigate the effects of sucralfate and proton pump inhibitors (PPI) on ventilator-associated pneumonia (VAP) of patients with mechanical ventilation in Intensive Care Unit. Methods: All of 90 cases which were not complicated with high risk factors of upper gastrointestinal bleeding were randomly divided into sucralfate group and PPI group. The patients of sucralfate group were given sucralfate for one week by nasal feeding, and PPI group were given pantoprazole for 3 days by intravenous injection. Two groups were treated with the same conventional therapy. The pH value of gastric juice and sputum culture of two groups patients were collected and tested. We also added up the incidence of VAP and upper gastrointestinal bleeding. Results: ①Four cases of sucralfate group and three cases of PPI group were expelled, because of inconformity the research standard. ②Compared with PPI group, pH value of gastric juice were lower significantly in sucralfate group (t=7.34,P＜0.01). ③The incidence of upper gastrointestinal bleeding of sucralfate group was 14.63%, higher than PPI group which was 9.52%, and the incidence of VAP of sucralfate group was 19.51%, lower than PPI group which was 21.43%, however, the differences were not statistically significant (P＞0.05). ④The difference in the distribution of etiology among the groups was not statistically significant (χ2=0.090,P=0.956). The most frequent isolates were gram-negative bacteria which accounted for 75.0% in 36 strains of pathogens. All of the resistant bacteria were found in late-onset VAP, and the most common was Acinetobacter baumannⅡ. The top three rates of total isolates pathogens were klebsiella pneumoniae, Acinetobacter baumannⅡ, and pseudomonas aeruginosa. Conclusion: In mechanical ventilation patients who are not complicated with high risk factors of upper gastrointestinal bleeding, the therapy of sucralfate and PPI has no effect on the incidence of VAP and upper gastrointestinal bleeding, and no difference on the VAP etiology distribution.
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Received: 28 July 2017
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Corresponding Authors:
Cai Jin-fang, E-mail: sweetheart1999@126.com
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