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PPI in intensive care

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https://www.readbyqxmd.com/read/28110095/prophylaxis-for-stress-ulcers-with-proton-pump-inhibitors-is-not-associated-with-increased-risk-of-bloodstream-infections-in-the-intensive-care-unit
#1
Margot E Cohen, Joanne M Hathway, Hojjat Salmasian, Jianfang Liu, Melissa Terry, Julian A Abrams, Daniel E Freedberg
BACKGROUND & AIMS: Proton pump inhibitors (PPIs) have been associated with increased risk of infection, likely because of changes in intestinal epithelial permeability and the gastrointestinal microbiome. PPIs are frequently given to patients in the intensive care unit (ICU) to prevent stress ulcers. These patients are at risk for bloodstream infections (BSIs), so we investigated the relationship between PPI use and BSIs among patients in the ICU. METHODS: We performed a retrospective cohort study of adults (≥18 years) admitted to 1 of 14 ICUs within a hospital network of 3 large hospitals from 2008 through 2014...
July 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28098980/ruthenium-ii-complex-based-luminescent-bifunctional-probe-for-ag-and-phosphate-ions-ag-assisted-detection-and-imaging-of-rrna
#2
Sanjoy Kumar Sheet, Bhaskar Sen, Romita Thounaojam, Kripamoy Aguan, Snehadrinarayan Khatua
A new bis-heteroleptic Ru(II) complex (1) of benzimidazole-substituted 1,2,3-triazole pyridine ligand has been designed and constructed for the photoluminescent detection of cationic and anionic analytes, Ag(+) and phosphate ions. Compound, 1[PF6]2 was fully characterized by various spectroscopic techniques and the solid-state structure was determined via single-crystal X-ray diffraction. The cation and anion sensing properties in 50% aqueous buffer (pH 9.2) and pure acetonitrile were carefully examined in photoluminescence (PL) spectroscopy...
January 18, 2017: Inorganic Chemistry
https://www.readbyqxmd.com/read/28093644/guidelines-for-proton-pump-inhibitor-prescriptions-in-paediatric-intensive-care-unit
#3
P Joret-Descout, S Dauger, M Bellaiche, O Bourdon, S Prot-Labarthe
Background Stress ulcer prophylaxis (SUP) is recommended in some situations to prevent upper gastrointestinal bleeding and is a component of standard care for patients admitted to the intensive care unit (ICU). Proton pump inhibitors (PPIs), already among the most widely prescribed drug classes, are being increasingly used. Objective To describe PPI prescribing patterns and their changes after the dissemination of guidelines. Setting Paediatric ICU (PICU), Robert-Debré Teaching Hospital, Paris, France, which admits about 800 patients annually, from full-term neonates to 18-year-olds...
February 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27903209/incidence-and-cost-of-stress-ulcer-prophylaxis-after-discharge-from-the-intensive-care-unit-a-retrospective-study
#4
MULTICENTER STUDY
Benedict Tan, Richard Norman, Ed Litton, Chloe Heath, David J Hawkins, Ravi Krishnamurthy, Ravikiran Sonawane, Matthew H Anstey
OBJECTIVE: To describe current patterns in initiation and cessation of proton pump inhibitors (PPIs) for stress ulcer prophylaxis (SUP) in intensive care units, and to assess the costs associated with inappropriate (non-evidence-based) SUP. DESIGN, SETTING AND PARTICIPANTS: Retrospective observational study in five ICUs in Western Australia. We assessed the medical records of consecutive patients admitted to the ICUs between September 2013 and January 2015. Patients aged < 18 years were excluded...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27900548/predictors-of-response-to-corticosteroids-for-dyspnea-in-advanced-cancer-patients-a-preliminary-multicenter-prospective-observational-study
#5
Masanori Mori, Akemi Naito Shirado, Tatsuya Morita, Kenichiro Okamoto, Yoshinobu Matsuda, Yoshihisa Matsumoto, Hirohide Yamada, Hiroki Sakurai, Etsuko Aruga, Keisuke Kaneishi, Hiroaki Watanabe, Takashi Yamaguchi, Takuya Odagiri, Shuji Hiramoto, Hiroyuki Kohara, Naoki Matsuo, Hideki Katayama, Tomohiro Nishi, Takashi Matsui, Satoru Iwase
PURPOSE: Although corticosteroids can relieve dyspnea in advanced cancer patients, factors predicting the response remain unknown. We aimed to explore potential factors predicting the response to corticosteroids for dyspnea in advanced cancer patients. METHODS: In this preliminary multicenter prospective observational study, we included patients who had metastatic or locally advanced cancer, were receiving specialized palliative care services, and had a dyspnea intensity of ≥3 on a 0-10 Numerical Rating Scale (NRS) (worst during the last 24 h)...
April 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27884335/pneumonia-prevention-in-intubated-patients-given-sucralfate-versus-proton-pump-inhibitors-and-or-histamine-ii-receptor-blockers
#6
COMPARATIVE STUDY
Gene A Grindlinger, Sarah B Cairo, Carole B Duperre
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common cause of infectious morbidity and mortality in the intensive care unit (ICU). The type of stress-ulcer prophylaxis (SUP) given to ventilated patients may, in part, be responsible. We observed an increase in VAP as ventilator bundle compliance increased and a decrease in VAP when bundle compliance decreased. We reasoned that SUP which raises gastric pH such as proton-pump inhibitors (PPIs) and histamine II (H2) receptor antagonists as opposed to SUP which does not raise pH such as sucralfate (S) may be responsible and also may alter the causative bacteria...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27809338/cost-effectiveness-of-histamine2-receptor-antagonists-versus-proton-pump-inhibitors-for-stress-ulcer-prophylaxis-in-critically-ill-patients
#7
Drayton A Hammond, Niranjan Kathe, Anuj Shah, Bradley C Martin
STUDY OBJECTIVE: To determine the cost-effectiveness of stress ulcer prophylaxis with histamine2 receptor antagonists (H2RAs) versus proton pump inhibitors (PPIs) in critically ill and mechanically ventilated adults. DESIGN: A decision analytic model estimating the costs and effectiveness of stress ulcer prophylaxis (with H2RAs and PPIs) from a health care institutional perspective. PATIENTS: Adult mixed intensive care unit (ICU) population who received an H2RA or PPI for up to 9 days...
January 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/27784575/the-appropriate-use-of-proton-pump-inhibitors-ppis-need-for-a-reappraisal
#8
REVIEW
Vincenzo Savarino, Pietro Dulbecco, Nicola de Bortoli, Andrea Ottonello, Edoardo Savarino
The advent of powerful acid-suppressive drugs, such as proton pump inhibitors (PPIs), has revolutionized the management of acid-related diseases and has minimized the role of surgery. The major and universally recognized indications for their use are represented by treatment of gastro-esophageal reflux disease, eradication of Helicobacter pylori infection in combination with antibiotics, therapy of H. pylori-negative peptic ulcers, healing and prophylaxis of non-steroidal anti-inflammatory drug-associated gastric ulcers and control of several acid hypersecretory conditions...
January 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/27686121/design-synthesis-and-evaluation-of-pyrazolo-pyrazole-derivatives-on-methylisocitratelyase-of-pseudomonas-aeruginosa-in-silico-and-in-vitro-study
#9
Madhusudana Pulaganti, Anuradha C M, Chitta Suresh Kumar
Pseudomonas aeruginosa is an opportunistic micro-organism causing diseases both in animals and humans. In case of human pathology, the role of P. aeruginosa is one of the major concerns in intensive care septicemia. Presently, the drug resistance strains of P. aeruginosa are arising mainly by developing multiple mechanisms due to its natural and acquired resistance to many of the antimicrobial agents commonly used in clinical practice. As a result, there is a direct need to invent new drugs so that they may restrict the outbreak of multidrug resistant strains...
February 20, 2017: Journal of Biomolecular Structure & Dynamics
https://www.readbyqxmd.com/read/27575714/proton-pump-inhibitors-do-not-increase-risk-for-clostridium-difficile-infection-in-the-intensive-care-unit
#10
David M Faleck, Hojjat Salmasian, E Yoko Furuya, Elaine L Larson, Julian A Abrams, Daniel E Freedberg
OBJECTIVES: Patients in the intensive care unit (ICU) frequently receive proton pump inhibitors (PPIs) and have high rates of Clostridium difficile infection (CDI). PPIs have been associated with CDI in hospitalized patients, but ICU patients differ fundamentally from non-ICU patients and few studies have focused on PPI use exclusively in the critical care setting. We performed a retrospective cohort study to determine the associations between PPIs and health-care facility-onset CDI in the ICU...
November 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27563320/comparative-study-on-the-influence-of-three-delivery-positions-on-pain-intensity-during-the-second-stage-of-labor
#11
Mahboubeh Valiani, Mehri Rezaie, Zahra Shahshahan
BACKGROUND: Labor is a physiologic process, and consideration of labor pain and relieving that is among the major components of maternal care. Application of some labor position can lay the fetus better in pelvic canal direction. The present study aimed to investigate the effect of laying the mother in three labor positions on the pain severity in the second, third, and fourth stages of labor. MATERIALS AND METHODS: This is a clinical trial conducted on 96 primiparous pregnant women randomly selected through convenient sampling from those who were hospitalized in the hospitals of Isfahan and Jahrom...
July 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/27543598/impact-of-a-pharmacist-driven-protocol-to-decrease-proton-pump-inhibitor-use-in-non-intensive-care-hospitalized-adults
#12
Jessica Michal, Thomas Henry, Connie Street
PURPOSE: Results of a pharmacist-driven protocol to decrease proton pump inhibitor (PPI) use in non-intensive care unit (ICU) hospitalized adults are presented. METHODS: This concurrent preintervention and postintervention study included subjects at least 18 years of age receiving PPIs while hospitalized in general medical or surgical beds. Patients were identified for inclusion in the postintervention group using a daily list of hospitalized patients with active PPI orders...
September 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27275859/high-dose-omeprazole-infusion-compared-with-scheduled-second-look-endoscopy-for-prevention-of-peptic-ulcer-rebleeding-a-randomized-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
Philip Wai Yan Chiu, Henry Kin Ming Joeng, Catherine Lai Yin Choi, Kelvin Kam Fai Tsoi, Kwok Hung Kwong, Siu Ho Lam, Joseph Jao Yiu Sung
BACKGROUND AND STUDY AIM: Previous studies have shown that both scheduled second-look endoscopy and high-dose continuous omeprazole infusion are effective in preventing peptic ulcer rebleeding. The aim of this noninferiority trial was to compare the efficacy of these two strategies for the prevention of rebleeding following primary endoscopic hemostasis. PATIENTS AND METHODS: Consecutive patients who received endoscopic treatment for bleeding peptic ulcers (actively bleeding, with nonbleeding visible vessels) were randomized to two treatment groups following hemostasis...
August 2016: Endoscopy
https://www.readbyqxmd.com/read/27131401/neonatal-histamine-2-receptor-antagonist-and-proton-pump-inhibitor-treatment-at-united-states-children-s-hospitals
#14
Jonathan L Slaughter, Michael R Stenger, Patricia B Reagan, Sudarshan R Jadcherla
OBJECTIVE: To determine treatment frequency and duration of histamine-2 receptor antagonist (H2RA)/proton pump inhibitor (PPI) use among infants hospitalized within US children's hospital neonatal intensive care units and evaluate diagnoses/demographic factors associated with use. STUDY DESIGN: We retrospectively analyzed a cohort of neonatal intensive care unit infants admitted to 43 US children's hospitals within the Pediatric Health Information System database between January 2006 and March 2013 to determine H2RA/PPI treatment frequency, timing/duration of treatment, factors associated with use, percent of infants remaining on treatment at discharge, and interhospital prescribing variation...
July 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27055405/prophylactic-proton-pump-inhibitors-in-femoral-neck-fracture-patients-a-life-and-cost-saving-intervention
#15
R Singh, R Trickett, Cer Meyer, S Lewthwaite, D Ford
Introduction Acute gastrointestinal stress ulceration is a common and serious complication of trauma. Prophylactic proton pump inhibitors (PPIs) or histamine receptor antagonists have been used in poly-trauma, burns and head and spinal injuries, as well as on intensive care units, for the prevention of acute gastric stress ulcers. Methods We prospectively studied the use of prophylactic PPIs in with femoral neck fracture patients, gathering data on all acute gastric ulcer complications, including coffee-ground vomiting, malena and haematemesis...
July 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27021503/risk-of-clostridium-difficile-infection-with-the-use-of-a-proton-pump-inhibitor-for-stress-ulcer-prophylaxis-in-critically-ill-patients
#16
Youngouk Ro, Chang Soo Eun, Hyun Soo Kim, Ji Yeoun Kim, Young Jae Byun, Kyo-Sang Yoo, Dong Soo Han
BACKGROUND/AIMS: Proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) are commonly prescribed for stress ulcer prophylaxis (SUP) in critically ill patients. Several studies have suggested that the use of PPIs is a potential risk factor for Clostridium difficile infection (CDI). We compared the incidences of CDI in the PPI group and H2RA group for SUP in critically ill patients. METHODS: From August 2005 to July 2012, the incidences of CDI were retrospectively analyzed in patients who were admitted directly to intensive care units and stayed for more than 3 days...
July 15, 2016: Gut and Liver
https://www.readbyqxmd.com/read/26911559/stress-ulcer-prophylaxis-in-critical-illness-a-canadian-survey
#17
Melissa Shears, Waleed Alhazzani, John C Marshall, John Muscedere, Richard Hall, Shane W English, Peter M Dodek, François Lauzier, Salmaan Kanji, Mark Duffett, Jeffrey Barletta, Mohammed Alshahrani, Yaseen Arabi, Adam Deane, Deborah J Cook
PURPOSE: Stress ulcer prophylaxis (SUP) using histamine-2-receptor antagonists has been a standard of care in intensive care units (ICUs) for four decades. Proton pump inhibitors (PPIs) are increasingly used despite apparently lower background rates of gastrointestinal bleeding and growing concerns about PPI-associated complications. Our objective was to understand the views and prescribing habits amongst Canadian physicians regarding SUP in the ICU and to gauge interest in a future randomized-controlled trial (RCT)...
June 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26855894/prevention-of-stress-related-ulcer-bleeding-at-the-intensive-care-unit-risks-and-benefits-of-stress-ulcer-prophylaxis
#18
REVIEW
Lukas Buendgens, Alexander Koch, Frank Tacke
Stress-related mucosal disease is a typical complication of critically ill patients in the intensive care unit (ICU). It poses a risk of clinically relevant upper gastrointestinal (GI) bleeding. Therefore, stress ulcer prophylaxis (SUP) is recommended in high-risk patients, especially those mechanically ventilated > 48 h and those with a manifest coagulopathy. Proton pump inhibitors (PPI) and, less effectively, histamine 2 receptor antagonists (H2RA) prevent GI bleeding in critically ill patients in the ICU...
February 4, 2016: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/26553337/defining-appropriate-use-of-proton-pump-inhibitors-among-medical-inpatients
#19
Matt Pappas, Sanjay Jolly, Sandeep Vijan
BACKGROUND: Proton-pump inhibitors (PPIs) are commonly used among medical inpatients, both for prophylaxis against upper gastrointestinal bleeding (UGIB) and continuation of outpatient use. While PPIs reduce the risk of UGIB, they also appear to increase the risk of hospital-acquired pneumonia (HAP) and Clostridium difficile infection (CDI). Depending upon the underlying risks of these conditions and the changes in those risks with PPIs, use of proton-pump inhibitors may lead to a net benefit or net harm among medical inpatients...
April 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/26092300/emergence-of-community-acquired-clostridium-difficile-infection-the-experience-of-a-french-hospital-and-review-of-the-literature
#20
REVIEW
Maja Ogielska, Philippe Lanotte, Cécile Le Brun, Anne Sophie Valentin, Denis Garot, Anne-Charlotte Tellier, Jean Michel Halimi, Philippe Colombat, Laurent Guilleminault, Bertrand Lioger, Hélène Vegas, Bertrand De Toffol, Thierry Constans, Louis Bernard
BACKGROUND: Clostridium difficile infection (CDI) is a common cause of nosocomial diarrhoea. People in the general community are not usually considered to be at risk of CDI. CDI is associated with a high risk of morbidity and mortality. The risk of severity is defined by the Clostridium Severity Index (CSI). METHODS: The cases of 136 adult patients with CDI treated at the University Hospital of Tours, France between 2008 and 2012 are described. This was a retrospective study...
August 2015: International Journal of Infectious Diseases: IJID
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