Ventilator-associated pneumonia among ICU patients receiving mechanical ventilation and prophylaxis of gastrointestinal bleeding

ABSTRACT

Pneumonia in ventilated intensive care unit [ICU] patients is one of the most serious nosocomial infections with a frequently fatal outcome. Retrograde colonization of the oropharynx from the stomach by micro-aspiration of gastric fluid was shown to be associated with pneumonia. The purpose of the present study was to compare the frequency of ventilator-associated pneumonia [VAP] between two groups of ICU patients taking gastrointestinal bleeding prophylaxis including ranitidine or omeprazole. This double-blind randomized clinical trial was achieved on 129 subjects receiving at least 48 hours mechanical ventilation. They were assigned in 2 groups of ranitidine and omeprazole as the prophylactic regimen of stress-related gastrointestinal bleeding. In ranitidine group, 6 patients [9.7%] developed VAP compared to 8 subjects [13.1%] in the other group, however, chi square analysis failed to show a significant difference [P=0.4]. The incidence of VAP in ICU patients receiving either ranitidine or omeprazole did not differ significantly, however, further studies with greater sample size are required to draw a firm decision