Proton pompa inhibitörlerinin yoğun bakım hastalarında gastrik volüm, gastrik pH ve gastrik intramukozal pH üzerine etkileri
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Dosyalar
Tarih
2005
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızda, yoğun bakım ünitesinde strese bağlı mukoza ülseri açısından risk grubunda olan hastalara verilen proton pompa inhibitörlerinin; gastrik pH, gastrik volüm, gastrik intramukozal pH, hemodinamik ve hematolojik paremetreler, PaO2, yoğun bakım ünitesinde kalış süresi, mortalite üzerine etkilerini karşılaştırmayı amaçladık. Çalışmaya 75 olgu alındı. Hastalar 15 'er kişiden oluşan 5 gruba ayrıldı. Grup O 'ya 20 mg omeprazol, Grup P'ye 40 mg pantoprazol, Grup E'ye 20 mg esomeprazol, Grup R'ye 20 mg rabeprazol 100 mi serum fizyolojik ile sulandırılarak nazogastrik yoluyla hastalara verilirken, kontrol grubuna sadece 100 mi serum fizyolojik verildi. Tüm gruplarda, demografik bulgular, yoğun bakım ünitesinde kalış süreleri, mortalite ve morbidite oranlan kaydedildi. Çalışmaya başlamadan önce, ilaç verildikten 2, 4 ve 6 saat sonra gastrik pH, gastrik volüm, gastrik intramukozal pH, hemodinamik parametreler, PaÛ2 değerleri kaydedildi. Çalışmaya başlamadan önce, ilaç verildikten 2, 6 ve 24 saat sonra hematolojik parametreler kaydedildi. Demografik veriler, yoğun bakım ünitesinde kalış süresi, mortalite, hemodinamik ve hematolojik parametreler, Pa02, gastrik intramukozal pH değerleri açısından gruplar arasında anlamlı bir farklılık saptanmadı (p>0.05). Başlangıç gastrik volüm ve gastrik pH değerleri açısından gruplar arasında fark saptanmazken ilaç verildikten sonraki 2, 4 ve 6. saatlerde yapılan takiplerde esomeprazol, pantoprazol ve rabeprazolün, kontrol ve omeprazol grubuna göre gastrik pH'yi anlamlı derecede artırdığı, gastrik volümü de anlamlı derecede azalttığı saptandı (pO.001). 52 Esomeprazol, pantoprazol ve rabeprazol grupları arasında gastrik pH, gastrik volüm açısından anlamlı bir farklılık saptanmadı (p>0.05). Sonuç olarak; proton pompa inhibitörlerinden esomeprazol, pantoprazol ve rabeprazolün, omeprazol ve kontrol grubuna göre daha etkin gastrik pH artışı ve gastrik volümü azalması sağlarken, gastrik intramukozal pH'yi etkilemediği saptandı. I
n our study, we aimed to compare effects of proton pump inhibitors on intensive care unit patients, who have risk factors for stress related mucosal disease, we evaluated for hemodynamic parameters (heart rate, mean arterial pressure), PaC«2, hematologic parameters, gastric intramucosal pH, gastric volume, gastric pH, duration of stay in the intensive care unit and mortality. Seventy-five patients were included in to our study. Cases of Group C were given only 100 ml serum physiologic, cases of Group O were given 20 mg omeprazole, cases of Group P were given 40 mg pantoprazole, cases of Group E were given 20 mg esomeprazole, cases of Group R were given 20 mg rabeprazole from nasogastric with 100 ml serum physiologic. Demographic findings, duration of stay in the intensive care unit and mortality were recorded in all groups. Gastric pH, gastric volume, gastric intramucosal pH, hemodynamic parameters, PaC>2 were recorded, before any medicine given and after giving the medicine at the 2nd, 4th and 6 hours. Before any medicine given, after giving the medicine, at the 6th and 24th hours, hematologic parameters were recorded. 54 There were no differences in relation to demographic findings, duration of stay in the intensive care unit, mortality, hemodynamic parameters, hematologic parameters, gastric intramucosal pH, PaC>2 amoung the groups. Initial gastric volume and gastric pH values were not statistically significant differences amoung all groups. In the 2nd, 4th and 6th hours, after giving pantoprazole, esomeprazole, rabeprazole gastric pH increase and gastric volume decrease statistically significant differences compared to omeprazole and control groups. In relation to gastric volume and gastric pH values, there were not statistically significant differences amoung pantoprazole, esomeprazole and rabeprazole groups. As a result, from the proton pump inhibitors pantoprazole, esomeprazole, rabeprazole were more effective in increasing gastric pH and decreasing gastric volume than omeprazole. In all proton pump ihibitors we used, there were no effect on gastric intramucosal pH.
n our study, we aimed to compare effects of proton pump inhibitors on intensive care unit patients, who have risk factors for stress related mucosal disease, we evaluated for hemodynamic parameters (heart rate, mean arterial pressure), PaC«2, hematologic parameters, gastric intramucosal pH, gastric volume, gastric pH, duration of stay in the intensive care unit and mortality. Seventy-five patients were included in to our study. Cases of Group C were given only 100 ml serum physiologic, cases of Group O were given 20 mg omeprazole, cases of Group P were given 40 mg pantoprazole, cases of Group E were given 20 mg esomeprazole, cases of Group R were given 20 mg rabeprazole from nasogastric with 100 ml serum physiologic. Demographic findings, duration of stay in the intensive care unit and mortality were recorded in all groups. Gastric pH, gastric volume, gastric intramucosal pH, hemodynamic parameters, PaC>2 were recorded, before any medicine given and after giving the medicine at the 2nd, 4th and 6 hours. Before any medicine given, after giving the medicine, at the 6th and 24th hours, hematologic parameters were recorded. 54 There were no differences in relation to demographic findings, duration of stay in the intensive care unit, mortality, hemodynamic parameters, hematologic parameters, gastric intramucosal pH, PaC>2 amoung the groups. Initial gastric volume and gastric pH values were not statistically significant differences amoung all groups. In the 2nd, 4th and 6th hours, after giving pantoprazole, esomeprazole, rabeprazole gastric pH increase and gastric volume decrease statistically significant differences compared to omeprazole and control groups. In relation to gastric volume and gastric pH values, there were not statistically significant differences amoung pantoprazole, esomeprazole and rabeprazole groups. As a result, from the proton pump inhibitors pantoprazole, esomeprazole, rabeprazole were more effective in increasing gastric pH and decreasing gastric volume than omeprazole. In all proton pump ihibitors we used, there were no effect on gastric intramucosal pH.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Yoğun Bakım Ünitesi, Gastrik pH, Gastrik Volüm, Gastrik İntramukozal pH, Proton Pompa İnhibitörleri, Intensive Care Unit, Gastric pH, Gastric Volume, Gastric Intramucosal pH, Proton Pump Inhibitors
