Randomized prospective evaluation of XXXX and antacid control of gastric pH in the critically ill.

@entity1 @entity4444 @entity295 @entity548 @entity542 @entity1576 @entity551 @entity356 @entity130
One hundred forty-four critically ill @entity1 admitted to an intensive care setting were randomly assigned to @entity4444 or antacid treatament groups. Gastric pH was monitored hourly. One hundred twenty-three (85%) @entity1 demonstrated a fall in pH to less than 4 and were considered to require prophylaxis. Prophylaxis was considered adequate if the measured pH could then be maintained at greater than or equal to 4. Fifty-eight @entity1 received antacids alone, the average requirement being 41 cc/hour. Sixty-five @entity1 received @entity4444 . Seventeen (26%) of the @entity4444 prophylaxis @entity1 failed to raise their pH and were than placed on hourly administration of antacid with successful elevations of pH to greater than or equal to 4 in all cases on an average supplementary dose of 53 cc/hour. Risk factors, including @entity295 , @entity551 , @entity542 , @entity1576 , degree of @entity130 , and age, were not statistically different in the two treated groups. Using these same criteria, responders to @entity4444 could not be differentiated from nonresponders. All @entity1 were protected from significant stress @entity548 while on this study. Significant complications of either treatment were minimal. Antacids offered consistent protection against @entity356 and were 100% effective. A routine schedule of 300 mg every six hours of @entity4444 was effective in only 47% of @entity1 , and the maximum dose of @entity4444 was effective in only 74% of @entity1 . Hourly measurement of intragastric pH is required for monitoring the response to prophylaxis of stress @entity548 in severely ill @entity1 .
