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  • Title: [Effect of stress ulcer prevention on the incidence of ventilation pneumonia at a pulmologic intensive care unit].
    Author: Wallner G, Armbruster C, Drlicek M, Heindl W, Koller A, Vetter N.
    Journal: Pneumologie; 1989 Nov; 43(11):665-8. PubMed ID: 2608643.
    Abstract:
    In a retrospective analysis, the influence of stress ulcer prophylaxis on the incidence of ventilation pneumonia (VP) was investigated. In VP, we were able to isolate enterobacteria from the tracheal aspirate or bronchial secretion significantly (p = 0.015) more frequently than in the case of environmentally acquired and nosocomial pneumonia which were treated in the intensive care unit but did not comply with the criteria for VP. The detection of intestinal bacteria in the respiratory tract in VP patients supports the hypothesis that the "gastro-pulmonary" colonisation pathway represents a decisive factor in the development of VP. Patients undergoing long-term ventilation who had received ranitidine for prophylaxis of stress ulcer, developed VP statistically significantly more frequently (p = 0.044) than did patients with sucralfat cover. The non-physiologically high acid juice pH associated with the use of H2-antagonists leads to an increase in intestinal organisms within the stomach. By ascending the upper GI tract, the bacteria finally colonise the respiratory tract. Through the application of sucralfat, whose ulcerprotective action is not achieved by the inhibition of acid in the stomach, the incidence of VP in a pulmological intensive care unit was reduced.
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