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Twenty-four-hour intragastric pH patterns in ICU patients on ranitidine

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Abstract

Thirty critically ill patients with mixed diagnoses underwent continuous intragastric pH monitoring for 72 hr while confined to a shock/trauma intensive care unit. The first 24 hr were monitored under no specific acid-suppressing therapy (placebo control). During the second and third consecutive 24-hr periods, patients received continuous infusion of intravenous ranitidine in the dose of 6.25 mg/hr and 12.5 mg/hr, respectively. Results of the placebo-control 24-hr study revealed that one third (N=10) of the patients were gastric acid hyposecretors (24-hr median intragastric pH values above pH 4.0). In the normosecreting group (N=20), both ranitidine schedules significantly elevated 24-hr median pH values, when compared to placebo (placebo 24-hr median intragastric pH 1.75; ranitidine 6.25 mg/hr 24-hr median intragastric pH 4.625,P<0.0001; ranitidine 12.5 mg/hr 24-hr median intragastric pH 6.29,P=0.0099). Five patients (18%) failed to adequately respond to the ranitidine 12.5 mg/hr dose (24-hr median intragastric pH<4.0). These findings suggest that a significant percentage of intensive care unit patients are not in need of acid-suppressing therapy as prophylaxis against stress-induced ulceration. Conversely, other patients may require more intensive acid-suppressing regimens because of failure to respond to high dose H2-antagonist therapy.

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Moore, J.G., Clemmer, T.P., Taylor, S. et al. Twenty-four-hour intragastric pH patterns in ICU patients on ranitidine. Digest Dis Sci 37, 1802–1809 (1992). https://doi.org/10.1007/BF01308071

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  • DOI: https://doi.org/10.1007/BF01308071

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