HealthDay News — Pantoprazole results in a significantly lower risk for clinically important upper gastrointestinal bleeding than placebo, with no increase in mortality, among patients undergoing invasive ventilation, according to a study published online June 14 in the New England Journal of Medicine to coincide with the annual Critical Care Reviews Meeting, held from June 12 to 14 in Belfast, Northern Ireland.
Deborah Cook, MD, from McMaster University in Hamilton, Ontario, Canada, and colleagues assigned critically ill adults who were undergoing invasive ventilation to receive intravenous pantoprazole (40mg daily) or matching placebo in an international randomized trial. Overall, 4821 patients in 68 intensive care units were randomly assigned.
The researchers found that clinically important upper gastrointestinal bleeding occurred in 25 of 2385 and 84 of 2377 patients receiving pantoprazole and placebo, respectively (1.0 vs 3.5%; hazard ratio, 0.30; 95% CI, 0.19 to 0.47; P <.001 death="" from="" any="" cause="" at="" days="" was="" reported="" in="" and="" percent="" of="" patients="" the="" pantoprazole="" placebo="" groups="" respectively="" ratio="" ci="" to="">P =.25). There was a reduction in patient-important bleeding with pantoprazole, but other key secondary outcomes did not differ between the groups.
“The use of pantoprazole resulted in a lower risk of clinically important upper gastrointestinal bleeding than the use of placebo, with no overall effect on mortality,” the authors write.
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