title: Stress ulcer prophylaxis in patients being weaned from the ventilator in a respiratory care center: A randomized control trial.
abstract: OBJECTIVE
  No data has been available on prophylaxis for stress ulcer development during the process of weaning patients off mechanical ventilators. We conducted a randomized study to evaluate the efficacy of stress ulcer prophylaxis with lansoprazole OD in patients being weaned from mechanical ventilators.
  
  
  METHODS
  A total of 120 patients were randomly allocated into two groups using blocked randomization, with 60 patients in each group. Group A was the treatment group, receiving lansoprazole OD 30 mg from a nasogastric tube for 14 days, while Group B, the control group, received no proton pump inhibitors or other medications for treating peptic ulcers. The primary end point of our study was apparent upper gastrointestinal bleeding within 2 weeks of enrollment.
  
  
  RESULTS
  Apparent upper gastrointestinal bleeding occurred in zero patients and five patients in Groups A and B, respectively (Group A: 0% vs. Group B: 8.3%, p = 0.057). There was no significant difference between the two groups in ventilator-associated pneumonia (Group A: 6.7% vs. Group B: 10.0%, p = 0.509) and 30-day survival rates (Group A: 96.7% vs. Group B: 100%, p = 0.496).
  
  
  CONCLUSIONS
  Stress ulcer prophylaxis with lansoprazole in patients being weaned from mechanical ventilators led to a lower but not statistically significant incidence of apparent upper gastrointestinal bleeding. There was no significant increase of incidence of ventilator-associated pneumonia in the prophylaxis group. Further larger scale studies are needed to clarify the benefit of stress ulcer prophylaxis in such patients.
authors: Division of Gastroenterology and Hepatology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors: Chien-Chu
authors: CC
authors: Lin
authors: Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Division of Thoracic Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors: Yeong-Long
authors: YL
authors: Hsu
authors: Division of Gastroenterology and Hepatology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
authors: Chen-Shuan
authors: CS
authors: Chung
authors: Division of Gastroenterology and Hepatology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan. Electronic address: thleekimo@yahoo.com.tw.
authors: Tzong-Hsi
authors: TH
authors: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D064747:Lansoprazole / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000517:prevention & control*; D010438:Peptic Ulcer Hemorrhage / Q000453:epidemiology*; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D012125:Respiratory Center; D013624:Taiwan; D016896:Treatment Outcome; D015300:Ventilator Weaning
chemical_list: D054328:Proton Pump Inhibitors; D064747:Lansoprazole
keywords: lansoprazole OD; proton pump inhibitor; respiratory care center; stress ulcer prophylaxis; weaning