COMPARATIVE STUDY OF PANTAPROZOLE AND SUCRALFATE ON INTRAGASTRIC PH IN PROPHYLAXIS OF ACUTE STRESS RELATED GASTRO INTESTINAL BLEEDING IN CRITICALLY ILL PATIENTS
Introduction: Stress-related mucosal damage (SRMD) is a significant cause of morbidity and mortality in critically ill patients due to the gastrointestinal blood loss. Prophylaxis of SRMD with proton pump inhibitors or histamine-2 blockers has gained widespread use in intensive care units. Both demonstrated to be effective in reducing clinically significant bleedings. Aim: The aim of the present study is an evaluation of prophylaxis with sucralfate and pantaprozole and their effects on intragastric pH and acute stress related GI bleeding. Materials and Methods: A total of 48 critically ill patients with risk factors of developing stress ulcer and intragastric pH < 3.0 enrolled to this randomized clinical trial study. Patients were randomly assigned in two treatment groups; Twenty four Patients were randomly assigned to 2 study groups. Group I Received syrup sucralfate 10 ml (1gm) 3 times a day through nasogastric tube. Group 2 Received intravenous bolus pantaprozole 40 mg once a day. Results: The demographic data were comparable without any statistically significance. The duration of study in both sucralfate and pantaprazole was comparable with p value >0.05. In the present study, there was significant differences in the type of risk factors between two groups 83% of patients in sucralfate had respiratory failure whereas the major cause of ICU admission in pantaprozole group was CNS injury (46%). Shock was seen in 43% of sucralfate group and 17% of pantapr0zole group. Medication related side effects i.e diarrhoea was seen in 2 patients of pantaprazole group. Baseline pH In both groups was seen in the same range with mean of 2.56 and 2.64 in the sucralfate and pantaprazole group. 5.7% of the samples on the sucralfate have PH<40 confirming its action of gastric mucosal protective agent without affecting the PH 67% in the pantaprazole group had pH >4.7. No significant overt bleeding was bleeding was found in the study groups. 38% in sucralfate group and 26% in pantaprazole group had occult bleeding. There was no significant difference in overt insignificant bleeding in either of the group (p>0.05).Conclusion: Both of them equally effective in the prevention of stress induced GI bleeding. No side effects are associated with pantaprazole and sucralfate