Effect of proton pump inhibitors on gastric volume, gastric pH and gastric intramucosal pH in critically ill patients in the ICU

Objective

In our study, we aimed to compare the effects of proton pump inhibitors in ICU patients with a control group for: hemodynamic parameters (heart rate, mean arterial pressure), hematologic parameters, gastric intramucosal pH, gastric volume, gastric pH, duration of stay in the ICU and mortality.

Materials and methods

Seventy-five patients were included in our study. Cases of Group C (n = 15) were given only 100 ml serum physiologic, cases of Group O (n = 15) were given 20 mg omepra-zole, cases of Group P (n = 15) were given 40 mg pantoprazole, cases of Group E (n = 15) were given 20 mg esomeprazole, and cases of Group R (n = 15) were given 20 mg rabeprazole from nasogastric with 100 ml serum physiologic. Demographic findings, the duration of stay in the ICU and mortality were recorded in all groups. Before any medicine was given, and after giving the medicine, in the second, fourth and sixth hours, the gastric pH, gastric volume, gastric intramucosal pH, hemodynamic parameters, and PaO₂ were recorded. Before any medicine was given, and after giving the medicine, in the second, fourth and 24th hours, hematologic parameters were recorded.

Results

There were no differences regarding demographic findings, duration of stay in the ICU, mortality, hemodynamic parameters, hematologic parameters, gastric intramucosal pH, and PaO₂ between all groups. The initial gastric volume and gastric pH values were not statistically significantly different between all groups. In the second, fourth and sixth hours, after giving medicine, in the pantoprazole, esomeprazole and rabeprazole groups the gastric pH increased and the gastric volume decreased statistically significantly compared with the omeprazole and control groups. In the gastric volume and gastric pH values, changes in the pantoprazole, esomeprazole and rabeprazole groups were not statistically significantly different between these groups.

Conclusion

The proton pump inhibitors pantoprazole, esomepra-zole and rabeprazole were more effective in increasing the gastric pH and decreasing the gastric volume than omeprazole. In all the proton pump inhibitors we used, there were no effects on the gastric intramucosal pH.