Effect of Ondansetron on Prevention of Ventilator Associated Pneumonia in Intensive Care Unit Patients in Kashani Hospital in 2013

Madineh, Hossein; Rahimi, Omolbanin; Zadeh, Mohamadreza Abedin; Kabiri, Majid

doi:10.7860/jcdr/2017/25859.10424

Cited by 2 publications

(2 citation statements)

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“…Furthermore, although no statistical difference was observed in the two groups after PSM in this study, the VAP incidence tended to decrease in the ondansetron group before and after PSM. Madineh et al ’s ( 32 ) study also showed that VAP in the ondansetron group was less prevalent than in the non-ondansetron group (12.5% vs. 15%). However, the sample size of 40 participants in their study was relatively small.…”

Section: Discussionmentioning

confidence: 89%

Association between ondansetron use and mortality of patients on mechanical ventilation in the intensive care unit: a retrospective cohort study

Tao¹,

Chen²,

Chang³

et al. 2023

Ann Transl Med

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Background Basic studies show that selective 5-hydroxytryptamine type 3 (5-HT 3 ) serotonin-receptor antagonists can protect organs from inflammatory injury and have shown lung protection. Whether 5-HT 3 receptor antagonists ondansetron benefits patients with mechanical ventilation is unclear in the intensive care unit (ICU). Methods The Medical Information Mart for Intensive Care-IV (MIMIC-IV) database was reviewed to identify patients on mechanical ventilation (aged >16 years) in the ICU, which was divided into two groups according to whether ondansetron is used. Demographic characteristics, medical history data, clinical parameters, diagnosis and treatment measures were included as covariates. Ondansetron use was defined as any kind of ondansetron administration regardless of the dose before the induction of mechanical ventilation. The primary outcome was in-hospital death. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated by multivariable Cox regression. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were performed to further adjust for confounding factors. Kaplan-Meier (KM) curves with log-rank test were also performed. Results A total of 18,566 patients on mechanical ventilation were included (5,735 with ondansetron use). The overall in-hospital mortality rate of patients on mechanical ventilation was 18.9% (3,512/18,566). Approximately 13.0% (746/5,735) and 21.6% (2,766/12,831) in-hospital mortality rates occurred in the ondansetron and non-ondansetron use groups, respectively. Multivariable regression indicated that ondansetron usage was associated with a 33% and 32% lower risk of in-hospital and 60-day death (HR =0.77, 95% CI: 0.70–0.85, P<0.001; HR =0.68, 95% CI: 0.62–0.75, P<0.001) in the whole sample. Multivariable regression post-PSM indicated that ondansetron usage was associated with a 38% and 31% lower risk of in-hospital and 60-day death (HR =0.62, 95% CI: 0.56–0.68, P<0.001; HR =0.69, 95% CI: 0.62–0.77, P<0.001). Log-rank test for the KM curve of ondansetron and 60-day death was statistically significant (P<0.001). The duration of ventilator use pre- and post-PSM was statistically different (P<0.001 and P=0.007) in the two groups. Conclusions Ondansetron usage was significantly associated with a lower mortality risk of ventilated patients in the ICU. The 5-HT3 receptor antagonist use is may be new potential adjunctive therapeutic strategy for patients on mechanical ventilation in the ICU.

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Section: Discussionmentioning

confidence: 89%

Association between ondansetron use and mortality of patients on mechanical ventilation in the intensive care unit: a retrospective cohort study

Tao¹,

Chen²,

Chang³

et al. 2023

Ann Transl Med

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“…Çalışma sonucunda nebülize kolistinin VİP insidansında anlamlı bir etkisinin olmadığını saptanmıştır (64). Madineh ve arkadaşlarının (2017) çalışma sonucu 4mg ondansetron uygulanan deney grubunda VİP insidansının kontrol grubundan daha düşük olduğunu, ancak bu farkın anlamlı olmadığını göstermiştir ve ayrıca çalışma sonucunda Ondansetron'un VİP önleme üzerinde etkisinin olmadığı tespit edilmiştir (76). van Delden ve arkadaşları (2012) tarafından yürütülen çalışmada 300 mg/ gün azitromisin verilen hastalarda VİP insidansında azalma eğiliminin olduğunu ve buna ek olarak azitromisinin, VİP riski yüksek olan hastalarda VİP'i önemli ölçüde önlediği sonuna varılmıştır (46).…”

Section: çAlışmalardan Elde Edilen Bulgularunclassified

Clinical Protocols for Ventilator Associated Pneumonia: A Systematic Study

Yıldırım¹,

Namık²,

Karahan³

et al. 2019

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Effect of Ondansetron on Prevention of Ventilator Associated Pneumonia in Intensive Care Unit Patients in Kashani Hospital in 2013

Abstract: Introduction: Ventilator Associated Pneumonia (VAP) is the second most common infection with high mortality (24-50%). Ondansetron is a reliable and safe drug and it is currently used in the prevention of nausea and vomiting and has no side effects.

Cited by 2 publications

References 19 publications

Association between ondansetron use and mortality of patients on mechanical ventilation in the intensive care unit: a retrospective cohort study

Association between ondansetron use and mortality of patients on mechanical ventilation in the intensive care unit: a retrospective cohort study

Clinical Protocols for Ventilator Associated Pneumonia: A Systematic Study

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