A prospective study of simplified omeprazole suspension for the prophylaxis of stress-related mucosal damage

Abstract

Simplified omeprazole suspension prevented clinically significant upper gastrointestinal bleeding and maintained gastric pH of > 5.5 in mechanically ventilated critical care patients without producing toxicity.

AASLD position paper: The management of acute liver failure

“…128 Limited studies of proton pump inhibitors (PPIs) as bleeding prophylaxis have demonstrated their effectiveness in maintaining elevated intragastric pH. [131][132][133] Two trials found no significant bleeding in PPI-treated patients on mechanical ventilation, 131,132 but study size may have precluded detection of significant bleeding. H 2 blockers have been proven to be effective and PPIs are almost certainly effective as well.…”

Nasogastric Administration of Omeprazole

“…No patient developed clinically significant upper GI bleeding while receiving omeprazole and the mean gastric pH increased significantly, from 3.5 (SD 1.9) before omeprazole administration to 6.8 (SD 0.6) after omeprazole administration. 11 N asogastric administration of 'simplified omeprazole suspension' has also been compared with continuous IV infusion of ranitidine in a randomised study. The study involved 58 patients with the same risk factors as those in the previous study.…”

Evidence on measures for the prevention of ventilator-associated pneumonia

“…Limited data exist on its clinical efficacy; however, available data indicate that proton-pump inhibitors can be efficacious [182][183][184][185][186]. In two prospective series of patients receiving omeprazole oral suspension [182,183], with sizes of 75 and 60 patients, respectively, clinically significant gastrointestinal bleeding was not experienced. In a randomised trial with 67 patients, a greater rate of clinically important bleeding (31 versus 6%, p,0.05), and a trend to a greater rate of VAP patients (14 versus 3%) was found in the patients given ranitidine intravenously versus omeprazole orally [184].…”