Pantoprazole Cuts GI Bleeding in Patients Undergoing Invasive Ventilation

MONDAY, June 17, 2024 (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, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues assigned critically ill adults who were undergoing invasive ventilation to receive intravenous pantoprazole (40 mg daily) or matching placebo in an international randomized trial. Overall, 4,821 patients in 68 intensive care units were randomly assigned.

The researchers found that clinically important upper gastrointestinal bleeding occurred in 25 of 2,385 and 84 of 2,377 patients receiving pantoprazole and placebo, respectively (1.0 versus 3.5 percent; hazard ratio, 0.30; 95 percent confidence interval, 0.19 to 0.47; P < 0.001). Death from any cause at 90 days was reported in 29.1 and 30.9 percent of patients in the pantoprazole and placebo groups, respectively (hazard ratio, 0.94; 95 percent confidence interval, 0.85 to 1.04; P = 0.25). 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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