caa a22 4500 606240705 CHVBK 20210128101309.0 cr unu---uuuuu 210128e20150101xx s 000 0 eng 10.1007/s00508-014-0637-y doi (NATIONALLICENCE)springer-10.1007/s00508-014-0637-y Effect of proton pump inhibitors on gastric pH in patients exposed to severe stress [Elektronische Daten] [Kurt Lenz, Robert Buder, Fritz Firlinger, Gerald Lohr, Martin Voglmayr] Einfluss von Protonenpumpenblockern auf den Magensaft pH von Patienten unter einer extremen Stresssituation Summary: Background: The incidence of upper gastrointestinal bleeding from stress ulcers has decreased within the last 30 years. Improvements in intensive care medicine including advanced equipment for artificial ventilation, better sedoanalgesic therapies, and the use of stress ulcer prophylaxis are credited for the decline. Objectives: To determine the effectiveness of proton pump inhibitors (PPIs) on gastric pH in patients exposed to a defined severe stress situation during a specified time period. Methods: Prospective open study in a tertiary community hospital. A high dose (80mg bolus followed by 8mg/h) of either pantoprazol or omeprazol was infused in 17 patients with opiate dependence who were undergoing ultra-rapid opiate withdrawal by barbiturate anesthesia. Mean outcome measure: Gastric pH. Results: Gastric pH did not change significantly in the majority of patients (mean pH 1.2±0.9 immediately before, 1.5±1.6 at 60min after, and 1.3±1.5 at 120min after PPI infusion began). Gastric pH increased temporarily in two of the nine patients receiving omeprazol. In two of the eight patients, pantoprazol led to a late but sustained increase in gastric pH (pH 3.9 and 6.0 at 120min post infusion). Conclusion: High doses of PPIs are ineffective in elevating gastric pH in patients exposed to severe stress such as ultra-rapid opiate detoxification. Therefore, adequate sedoanalgesia might be the main factor responsible for preventing stress-related bleeding in critically ill patients. Springer-Verlag Wien, 2014 Acid suppression nationallicence Stress ulcer prophylaxis nationallicence Proton pump inhibitor nationallicence Stressulkusprophylaxe nationallicence Säureblockade nationallicence Lenz Kurt Department of Internal Medicine and Intensive Care Medicine, Konventhospital Barmherzige Brueder Linz, Seilerstaette 2, 4021, Linz, Austria aut Buder Robert Department of Internal Medicine and Intensive Care Medicine, Konventhospital Barmherzige Brueder Linz, Seilerstaette 2, 4021, Linz, Austria aut Firlinger Fritz Department of Internal Medicine and Intensive Care Medicine, Konventhospital Barmherzige Brueder Linz, Seilerstaette 2, 4021, Linz, Austria aut Lohr Gerald Department of Internal Medicine and Intensive Care Medicine, Konventhospital Barmherzige Brueder Linz, Seilerstaette 2, 4021, Linz, Austria aut Voglmayr Martin Department of Internal Medicine and Intensive Care Medicine, Konventhospital Barmherzige Brueder Linz, Seilerstaette 2, 4021, Linz, Austria aut Wiener klinische Wochenschrift Springer Vienna 127/1-2(2015-01-01), 51-56 0043-5325 127:1-2<51 2015 127 508 https://doi.org/10.1007/s00508-014-0637-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00508-014-0637-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lenz Kurt Department of Internal Medicine and Intensive Care Medicine, Konventhospital Barmherzige Brueder Linz, Seilerstaette 2, 4021, Linz, Austria aut NATIONALLICENCE 700 1- Buder Robert Department of Internal Medicine and Intensive Care Medicine, Konventhospital Barmherzige Brueder Linz, Seilerstaette 2, 4021, Linz, Austria aut NATIONALLICENCE 700 1- Firlinger Fritz Department of Internal Medicine and Intensive Care Medicine, Konventhospital Barmherzige Brueder Linz, Seilerstaette 2, 4021, Linz, Austria aut NATIONALLICENCE 700 1- Lohr Gerald Department of Internal Medicine and Intensive Care Medicine, Konventhospital Barmherzige Brueder Linz, Seilerstaette 2, 4021, Linz, Austria aut NATIONALLICENCE 700 1- Voglmayr Martin Department of Internal Medicine and Intensive Care Medicine, Konventhospital Barmherzige Brueder Linz, Seilerstaette 2, 4021, Linz, Austria aut NATIONALLICENCE 773 0- Wiener klinische Wochenschrift Springer Vienna 127/1-2(2015-01-01), 51-56 0043-5325 127:1-2<51 2015 127 508