Role of Proton Pump Inhibitor as Stress Ulcer Prophylaxis in Sick Children: A Randomized Controlled Trial

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dc.contributor.authorKavilapurapu, Ananyaen_US
dc.contributor.authorLalitha, AVen_US
dc.contributor.authorGhosh, Santuen_US
dc.date.accessioned2025-08-13T09:09:41Z
dc.date.available2025-08-13T09:09:41Z
dc.date.issued2025-06
dc.description.abstractOBJECTIVES To evaluate the efficacy of intravenous pantoprazole as a stress ulcer prophylaxis in sick children to prevent gastrointes?nal (GI) bleeding. METHODS A randomized controlled trial included children aged one-month to 18 years requiring intensive care. Par?cipants were randomly assigned to receive intravenous pantoprazole or a placebo (normal saline) daily. The primary outcome was the incidence of GI bleeding (clinically significant or overt). Secondary outcomes were the median ?me of onset of GI bleeding, incidence of ven?lator- associated pneumonia (VAP), dura?on of hospitaliza?on, organ dysfunc?on scores, and all-cause mortality. RESULTS A total of 151 and 150 children were allocated to group A (pantoprazole) and group B (placebo), respec?vely. No significant difference was observed in the incidence of GI bleeding between the groups (group A: 21/151 vs group B: 19/150 [RR (95% CI) 1.03 (0.18, 5.82), P = 0.985]. Comparable results were observed for clinically significant GI bleeding (1.3% vs 0.6%; RR (95% CI) 0.54 (0.21, 1.28); P = 0.653 and overt GI bleeding [12.6% vs 12%; RR (95% CI) 0.98 (0.39, 2.23); P value = 0.313]. On mul?variate analysis, there was a reduced incidence of GI bleeding in children with coagulopathy in pantoprazole group ( n = 29) as compared to placebo ( n = 25) [RR (95%CI) 0.52 (0.32, 0.87); P = 0.022]. CONCLUSION Among cri?cally ill children, pantoprazole prophylaxis did not reduce the incidence of gastrointes?nal bleeding, although, a notable decrease in gastrointes?nal bleeding was observed in children with coagulopathy.en_US
dc.identifier.affiliationsDepartment of Pediatric Critical Care, St. John’s Medical College and Hospital, Bengaluru, Karnataka, Indiaen_US
dc.identifier.affiliationsDepartment of Pediatric Critical Care, St. John’s Medical College and Hospital, Bengaluru, Karnataka, Indiaen_US
dc.identifier.affiliationsDepartment of Biostatistics, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India.en_US
dc.identifier.citationKavilapurapu Ananya, Lalitha AV, Ghosh Santu . Role of Proton Pump Inhibitor as Stress Ulcer Prophylaxis in Sick Children: A Randomized Controlled Trial. Indian Pediatrics. 2025 Jun; 62(6): 407-413en_US
dc.identifier.issn0019-6061
dc.identifier.issn0974-7559
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/251345
dc.languageenen_US
dc.publisherIndian Academy of Pediatricsen_US
dc.relation.issuenumber6en_US
dc.relation.volume62en_US
dc.source.urihttps://indianpediatrics.net/june2025/407.pdfen_US
dc.subjectCritically ill childrenen_US
dc.subjectPPIen_US
dc.subjectStress ulcer prophylaxisen_US
dc.subjectPantoprazoleen_US
dc.subjectGI bleedingen_US
dc.titleRole of Proton Pump Inhibitor as Stress Ulcer Prophylaxis in Sick Children: A Randomized Controlled Trialen_US
dc.typeJournal Articleen_US
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