Plasma aluminum concentrations in long-term mechanically ventilated patients receiving stress ulcer prophylaxis with sucralfate.
OBJECTIVE
To determine plasma aluminum concentrations and 24-hr urine aluminum excretion rate in long-term mechanically ventilated patients treated with 6 g of sucralfate daily for stress ulcer prophylaxis.


METHODS
Prospective study in long-term mechanically ventilated critically ill patients.


METHODS
A surgical intensive care unit at a university hospital.


METHODS
Eleven long-term mechanically ventilated patients (multiple trauma [n = 8], abdominal surgery [n = 3]) were included in the study. The mean age of the patients was 57.2 +/- 10.8 yrs and the mean duration of treatment was 11.3 +/- 4.2 days.


METHODS
1 g of sucralfate suspension intragastrically six times daily.


RESULTS
Baseline plasma aluminum concentrations were determined at the beginning of the study. Patients received 1 g of sucralfate suspension given intragastrically six times daily via a nasogastric tube. Daily plasma aluminum concentration was measured 3 hrs after the morning dose of sucralfate. The urine aluminum excretion rate was determined from the 24-hr urine samples. Determinations of plasma and urine aluminum concentrations were carried out by flameless atomic absorption spectrophotometry. Renal function was compromised in eight patients (maximum plasma creatinine concentration 2.7 mg/dL [238.7 mumol/L]; normal value < 1.4 mg/dL [< 123.8 mumol/L]). Mean daily plasma aluminum concentration varied between 7.5 +/- 1.6 micrograms/L (278 +/- 59.3 nmol/L) and 21.1 +/- 7.1 micrograms/L (782 +/- 263.1 nmol/L) (normal value < 10 micrograms/L [< 371 nmol/L]). The 24-hr urine aluminum excretion rate varied between 25.7 +/- 18.1 and 53.4 +/- 87.2 micrograms/L (952.4 +/- 671 and 1979 +/- 3232 nmol/L) (normal value < 12.2 micrograms/L [< 452 nmol/L]). Aluminum accumulation did not occur in any of the patients.


CONCLUSIONS
The administration of 6 g of sucralfate daily in long-term mechanically ventilated surgical patients did not result in an increase in the plasma aluminum concentration. Sucralfate can be administered safely for a period of at least 2 wks, even in critically ill patients with impaired renal function.
Tryba
M
M
Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Bergmannsheil Bochum, FRG.
Kurz-Müller
K
K
Donner
B
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000535:Aluminum / Q000097:blood* / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D011446:Prospective Studies; D012121:Respiration, Artificial; D013054:Spectrophotometry, Atomic; D018709:Statistics, Nonparametric; D013312:Stress, Physiological / Q000150:complications / Q000453:epidemiology / Q000378:metabolism / Q000517:prevention & control*; D013392:Sucralfate / Q000008:administration & dosage*; D013535:Suspensions; D013997:Time Factors
D013535:Suspensions; D013392:Sucralfate; D000535:Aluminum