Ventilator-associated pneumonia and upper airway colonisation with Gram negative bacilli: the role of stress ulcer prophylaxis in children.
OBJECTIVE
To assess the risk of ventilator-associated pneumonia (VAP) and the incidence of upper airway colonisation related to the use of stress ulcer prophylaxis in critically ill children.


METHODS
Retrospective study.


METHODS
Paediatric intensive care unit (PICU) of a tertiary care centre.


METHODS
All children who were mechanically ventilated for more than 48 h.


METHODS
None.


RESULTS
A total of 54 patients were given ranitidine, 53 patients were given sucralfate and 48 patients were given no stress ulcer prophylaxis. Thirteen (8.4%) patients developed VAP: 6 (11.1%) patients in the ranitidine group, 4 (7.5%) in the sucralfate group and 3 (6.2%) in the group without prophylaxis. The rate of upper airway colonisation with Gram negative bacilli was 25.9% (14/54) in the ranitidine group, 22.6% (12/53) in the sucralfate group and 37.5% (18/48) in the group without prophylaxis. The differences among the groups were not significant.


CONCLUSIONS
In contrast to findings in adults, we found that, in children, sucralfate does not decrease the incidence of VAP or the incidence of upper airway colonisation with Gram negative bacilli as compared to ranitidine or no stress ulcer prophylaxis. However, the small sample size and study design substantially limit our conclusions.
Lopriore
Enrico
E
Department of Paediatric Intensive Care, VU University Medical Centre, De Boelelaan 1117, 1007 MB Amsterdam, PO Box 7057, The Netherlands.
Markhorst
Dick G
DG
Gemke
Reinoud J B J
RJ
D000293:Adolescent; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D010437:Peptic Ulcer / Q000517:prevention & control*; D018410:Pneumonia, Bacterial / Q000209:etiology*; D011899:Ranitidine / Q000627:therapeutic use*; D012121:Respiration, Artificial / Q000009:adverse effects*; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000150:complications*; D013392:Sucralfate / Q000627:therapeutic use*
D000897:Anti-Ulcer Agents; D013392:Sucralfate; D011899:Ranitidine