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Ranitidine is unable to maintain gastric pH levels above 4 in septic patients.

Author(s): Terzi Coelho CB, Dragosavac D, Coelho Neto JS, Montes CG, Guerrazzi F, Andreollo NA

Affiliation(s): Intensive Care Unit, Teaching Hospital of the State University of Campinas, Campinas, Sao Paulo, Brazil. cristerzi@gmail.com

Publication date & source: 2009-12, J Crit Care., 24(4):627.e7-13.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

PURPOSE: The study aimed to evaluate whether ranitidine and pantoprazole are able to maintain gastric pH >or=4 in septic patients. MATERIALS AND METHODS: Twenty intensive care unit patients from a university teaching hospital with sepsis were included in this study. Ten patients received ranitidine (50 mg as an intermittent bolus 3 times a day) and 10 received pantoprazole (40 mg as an intermittent bolus twice a day). Gastric pH was measured continuously for 48 hours. Endoscopy of the upper digestive tract, gastric biopsy, and investigation for Helicobacter pylori were carried out before and at the end of the study. RESULTS: pH values >or=4 were maintained for 46.27% +/- 38.21% and 81.57% +/- 19.65% of study time in the ranitidine and pantoprazole groups, respectively (P = .04). CONCLUSIONS: Intravenous ranitidine was unable to maintain gastric pH above 4 in septic patients. All cases in the ranitidine group in whom pH remained above 4 had gastric hypotrophy or atrophy. Pantoprazole successfully maintained pH levels above 4.

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