Effects of rabeprazole or famotidine during cardiac surgery on perioperative gastric and esophageal pH readings

Gon, Shigeyoshi; Irie, Yoshihito; Takahashi, M

doi:10.1007/pl00022253

Cited by 5 publications

(1 citation statement)

References 12 publications

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“…Munakatar et al [23] did not find a relation between gastric acid secretion and stress ulceration. Some studies demonstrated suppression of acid secretion and benefit in patients given routine stress ulcer prophylaxis [24,25]. These results suggest that acute acid secretion may contribute to stress peptic ulcer.…”

Section:  Physiological Stressmentioning

confidence: 89%

Stress gastric ulcer after cardiac surgery: Pathogenesis risk factors and medical management

Houssa¹,

Atmani²,

Nya³

et al. 2013

WJCD

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Stress ulcer lesions of upper gastrointestinal tract are well recognized in patients undergoing open cardiac surgery. Gastrointestinal bleeding following cardiac surgery is infrequent with significant morbidity and mortality. The pathogenesis of mucosal lesions and subsequent haemorrhage is complex and multifactorial. The diagnosis as well as the treatment of this complication remains a challenge for surgeons. Identifying the source of bleeding can be difficult. Despite of the successful control of haemorrhage using various combinations of endoscopic and pharmacological therapies, the mortality rate remains unchanged. Benefit of routine stress ulcer prophylaxis remains controversial.

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Section:  Physiological Stressmentioning

confidence: 89%

Stress gastric ulcer after cardiac surgery: Pathogenesis risk factors and medical management

Houssa¹,

Atmani²,

Nya³

et al. 2013

WJCD

View full text Add to dashboard Cite

show abstract

Meta-analysis: Comparative efficacy of H2-receptor antagonists and proton pump inhibitors for reducing aspiration risk during anaesthesia depending on the administration route and schedule

Puig

Calzado

Suarez

et al. 2012

Pharmacological Research

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Is routine stress ulcer prophylaxis of benefit for patients undergoing cardiac surgery?

Shin

Abah

2012

Interactive CardioVascular and Thoracic Surgery

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A best evidence topic in cardiac surgery was written according to a structured protocol. We address whether routine pharmacological stress ulcer prophylaxis is of benefit for patients undergoing cardiac surgery. One hundred and fifty-six papers were found using the reported search, of which 10 represented the best evidence to answer the clinical question. The authors, journal, date, country of publication, patient group, study type, relevant outcomes and results of these papers were tabulated. The results show that the incidence of stress ulcers following cardiac surgery is low (0.45%), but remains associated with significant morbidity and mortality. Five of the 7 studies demonstrated suppression of acid secretion or decreased incidence of gastric complications in patients given pharmacological stress ulcer prophylaxis, with the remaining two suggesting no clinical benefit. One prospective study of 210 patients, randomized equally between a proton pump inhibitor (PPI), histamine antagonist and teprenone, found that PPIs were the most effective at reducing gastric complications after cardiac surgery, including ulcer formation and upper gastrointestinal bleeding (UGIB). However, a separate retrospective study suggested no difference in the outcomes between the use of a PPI and a histamine antagonist. Of the studies focused on histamine antagonists, one randomized control trial (RCT) showed that cimetidine can reduce surgical stress, augment the immune system and reduce the intubation time after cardiac surgery, although no direct association with UGIB was made. A second prospectively randomized study of histamine antagonists demonstrated superior pH control with famotidine and ranitidine, when compared with cimetidine. Furthermore, haematological and neurological side-effects were noted only with the use of cimetidine. A recent meta-analysis and systematic review of the literature associated gastric acid suppression with an increased risk of pneumonia. Two prospective cohort studies that examined the use of PPI in conjunction with clopidogrel in patients with coronary artery disease concluded that there was no association with an increase in major adverse cardiovascular events with the use of PPIs. We conclude that the current evidence is marginally in favour of the use of prophylactic PPIs. However, this is associated with an increased risk of hospital-acquired pneumonia.

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Effects of rabeprazole or famotidine during cardiac surgery on perioperative gastric and esophageal pH readings

Abstract: The FAM group and RPZ group revealed a sufficient effect of gastric acid suppression. It was indicated that FAM had an insufficient effect of gastric acid suppression for HP-negative patients.

Cited by 5 publications

References 12 publications

Stress gastric ulcer after cardiac surgery: Pathogenesis risk factors and medical management

Stress gastric ulcer after cardiac surgery: Pathogenesis risk factors and medical management

Meta-analysis: Comparative efficacy of H2-receptor antagonists and proton pump inhibitors for reducing aspiration risk during anaesthesia depending on the administration route and schedule

Is routine stress ulcer prophylaxis of benefit for patients undergoing cardiac surgery?

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