Effect of a 2 g cimetidine infusion on twenty-four-hour intragastric pH in critically ill patients.
We evaluated the effect of a cimetidine continuous infusion (2 g in 24 h) on the intragastric pH of 16 critically ill patients (11 men, 5 women, mean age 45 years). During the 24 h pre-trial period and the subsequent 24 h cimetidine infusion, an intragastric combined electrode was placed in the fundus and the pH recorded with a portable pH module and data collection unit. In each patient, the cimetidine infusion induced a prolonged rise of intragastric pH. For all patients the mean percentage of readings above pH 4.0 was 11% pre-trial and 75% during the cimetidine 24 h infusion (p less than 0.001). The percentages of readings above 5.0, 6.0, 7.0 were also significantly higher during infusion than pre-trial in the 16 patients. After starting the cimetidine infusion, there was a concomitant rise of median plasma cimetidine and median intragastric pH in the 7 patients studied. After 6 h, median plasma cimetidine remained above 1 mcg/ml. These results and recent data from the literature suggest that in critically ill patients a continuous infusion of cimetidine might prevent stress ulcerations better than bolus injections by maintaining intragastric pH above 4.0 during longer time intervals.
Tomé
G
G
Gastroenterology Unit, Cliniques St-Luc, UCL, Bruxelles, Belgium.
Fiasse
R
R
Reynaert
M
M
Mahieu
P
P
Hanssens
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002927:Cimetidine / Q000008:administration & dosage / Q000627:therapeutic use*; D003422:Critical Care; D005260:Female; D005745:Gastric Acidity Determination; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D013276:Stomach Ulcer / Q000209:etiology / Q000517:prevention & control*; D013312:Stress, Physiological / Q000150:complications*; D013997:Time Factors
D002927:Cimetidine