The Effectiveness of Standard Single Dose Omeprazole vs. High Dose Continuous Infusion in High-risk Critically Ill Patients

Objectives: The present study was carried out to investigate the beneficial effects of high dose omeprazole versus standard low dose as a prophylaxis against upper GIT bleeding in high risk critically ill patients. Methods: A hundred and ten high risk critically ill patients were divided into two groups, fifty-five patients each. Group A received intravenous (IV) omeprazole 40 mg bolus dose once daily followed by normal saline infusion. Group B received IV bolus of 80 mg omeprazole followed by 8 mg/h infusion. The treatment was for the whole period of ICU stay. Early morning gastric pH, residual gastric volume, signs of significant upper GIT bleeding, ICU stay Hb, number of ICU days without ventilator, ICU stay hemoglobin (Hb), number of red cell units transfused in ICU, ICU stay, and numbers of ICU survivors were recorded. Results: Gastric pH was higher in group B compared to group A (p<0.05). The number of patients developed significant upper GIT bleeding were significantly higher in group A. Group A had lower ICU Hb levels and used significant higher number of RBC units. ICU stay was significantly higher in group A compared to group B (p=0.02). There were no statistical differences regarding the number of ICU days without ventilator and ICU survivors between both groups (P<0.05). Conclusions: High dose PPI continuous infusion can reduce the incidence of upper GIT bleeding in high risk critically ill patients. High dose PPI can reduce ICU stay with no effect on ICU survivor rate.