Occurrence of nosocomial pneumonia in mechanically ventilated trauma patients: a comparison of sucralfate and ranitidine.
OBJECTIVE
To determine if there is a difference in nosocomial pneumonia frequency rate in mechanically ventilated trauma patients treated with sucralfate vs. ranitidine for stress ulcer prophylaxis.


METHODS
Prospective, randomized trial.


METHODS
A 640-bed urban teaching hospital and trauma center.


METHODS
Ninety-two mechanically ventilated trauma patients.


METHODS
Thirty-nine patients received sucralfate and 44 patients received intravenous ranitidine for stress ulcer prophylaxis; nine patients were excluded from the study for protocol breaks.


RESULTS
The study population was severely injured and critically ill. The Trauma Score averaged 11.3, the Injury Severity Score averaged 27.7, and the Acute Physiology and Chronic Health Evaluation (APACHE) score averaged 18.1. There were no significant differences in demographics, mechanisms of injury, Trauma Score, Injury Severity Score, APACHE score, length of hospital stay, length of surgical intensive care unit stay, or duration of endotracheal intubation between the sucralfate and ranitidine groups. Eleven (13.2%) patients developed nosocomial pneumonia: six (15.4%) of 39 patients in the sucralfate group and five (11.4%) of 44 patients in the ranitidine group; these numbers were not significantly different (chi 2 = 0.0226, p = .8805). There were no episodes of significant upper gastrointestinal bleeding. Six patients died during hospitalization, all secondary to severe head injury and none with pneumonia.


CONCLUSIONS
There was no statistically significant difference in pneumonia rate in mechanically ventilated trauma patients receiving stress ulcer prophylaxis with sucralfate vs. ranitidine.
Pickworth
K K
KK
Grant Medical Center, Columbus, OH 43215.
Falcone
R E
RE
Hoogeboom
J E
JE
Santanello
S A
SA
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology* / Q000382:microbiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009104:Multiple Trauma / Q000145:classification / Q000150:complications* / Q000401:mortality / Q000628:therapy; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000209:etiology; D011014:Pneumonia / Q000453:epidemiology* / Q000209:etiology* / Q000382:microbiology; D011446:Prospective Studies; D011899:Ranitidine / Q000009:adverse effects*; D012121:Respiration, Artificial / Q000009:adverse effects*; D013312:Stress, Physiological / Q000188:drug therapy* / Q000209:etiology; D013392:Sucralfate / Q000009:adverse effects*; D015599:Trauma Severity Indices
D000900:Anti-Bacterial Agents; D013392:Sucralfate; D011899:Ranitidine