Ventilator-associated pneumonia and upper airway colonisation with Gram negative bacilli: the role of stress ulcer prophylaxis in children
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Objective. To assess the risk of ventilator-associated pneumonia (VAP) and the incidence of upper airway colonisation related to the use of stress ulcer prophylaxis in critically ill children.
Design. Retrospective study.
Setting. Paediatric intensive care unit (PICU) of a tertiary care centre.
Patients. All children who were mechanically ventilated for more than 48 h.
Results. A total of 54 patients were given ranitidine, 53 patients were given sucralfate and 48 patients were given no stress ulcer prophylaxis. Thirteen (8.4%) patients developed VAP: 6 (11.1%) patients in the ranitidine group, 4 (7.5%) in the sucralfate group and 3 (6.2%) in the group without prophylaxis. The rate of upper airway colonisation with Gram negative bacilli was 25.9% (14/54) in the ranitidine group, 22.6% (12/53) in the sucralfate group and 37.5% (18/48) in the group without prophylaxis. The differences among the groups were not significant.
Conclusions. In contrast to findings in adults, we found that, in children, sucralfate does not decrease the incidence of VAP or the incidence of upper airway colonisation with Gram negative bacilli as compared to ranitidine or no stress ulcer prophylaxis. However, the small sample size and study design substantially limit our conclusions.
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