The results of intragastric рH-monitoring related to stress ulcer prophylaxis method in comatose patients

Abstract

Aim. Analyzing dynamics of intragastric рН related to stress ulcer prophylaxis method in comatose patients. Materials and Methods. The prospective study included 100 comatose patients with brain stroke with consciousness level of 5-8 by Glasgow Coma Scale. All patients were given tube enteral nutrition . The patients were divided into three groups: group HB (n=18) received Н-2-histamine blocker agent; group IPI (n=38) received ion pump inhibitor, and group EN (n=44) received no medication for stress ulcer prophylaxis. The maximal, minimal and average daily intragastric рН levels were analyzed on the 1st, 3rd, and 5th days of stay in the intensive care unit. Results and Discussion. The average daily intragastric pH level in group HB was 2,4±0,44 on day 1,- 4,54±1,5 on day 3, and- 3,85±0,77 on day 5. This parameter in the group IPI was 1,66±0,45 on day 1, 5,9±1,43 on day 3, and 5,37±1,44 on day 5; in the group EN: 2,98±0,65 on day 1,- 3,41±0,45 on day 3, and 3,45±0,5 on day 5. Conclusions. Early enteral nutrition ensures the optimal level of intragastric pH. The ion pump inhibitors provide more potent inhibition of acidity of gastric content compared to the Н-2-histamine blocker agents. Intragastric рН-monitoring is useful in evaluating the stress ulcer prophylaxis effectiveness in comatose patients.

Keywords

• stress ulcer prophylaxis, intragastric рн, coma, brain stroke