Sucralfate versus omeprazole as a prophylaxis of upper gastro intestinal tract bleeding in ventilated and in critically III non-ventilated children

ABSTRACT

Upper gastrointestinal bleeding [UGITB] complications in the form of mucosal congestion, ulceration and bleeding related to stress-related mucosal disease [SRMD] will lengthen hospitalization and increase mortality intensive care unit [ICU]. Several medications were tried to prevent SRMD. to compare the efficacy of oral Sucralfate [OS] versus IV omeprazole [IVO] for prophylaxis of UGITB in mechanically ventilated and in critically ill non-ventilated patients. 10-months observational controlled study. Setting: Pediatric ICU, Pediatric Department, Tanta University Hospital Patients and Methods: 60 pediatric patients were included 30 males and 30 females. In every patient; SOFA scoring, Gastric juice aspirate samples were examined for occult blood and aspirate pH bypH meter. In 40 patients either OS or IVO was started by 3 day of admission and continued for 4 days. No UGITB prophylactic therapy was given to 20 patients [controls]. In patients receiving OS There was insignificant decrease in gastric bleeding [GB] and increase in gastric pH in comparison to controls; and in patients after OS than before. In patients receiving IVO the unventilated patients showed significant decrease in GB cases and increase in gastric pH in comparison to controls; and in patients after IVO than before. The ventilated patients showed insignificant decrease in GB cases in comparison to controls; and in patients after IVO than before. Also, there was significant increase in pH in unventilated and ventilated IVO group in comparison to controls, and in after IVO than before. Conclusions: OS may not be the appropriate choice for SUP due to its limited effects on UGITB and gastric pH. Meanwhile, IVO reduce UGITB in a higher proportion of patients and increase gastric pH to higher levels. So, it may be the SUP drug of choice in high-risk patients