Prediction of Ventilator-Associated Pneumonia in Patients Undergoing Stress Ulcer Prophylaxis: A Longitudinal Descriptive Study in Iran

Background: The purpose of this study was to investigate and predict ventilator-associated pneumonia (VAP) in the two groups of patients who received either proton pump inhibitors (Pantoprazole) or histamine H۲ antagonist (Ranitidine). Methods: Patients in ICU received Pantoprazole or Ranitidine as stress-related mucosal injury and GI bleeding prophylaxis. The incidence rate of VAP and GI bleeding was estimated in each group during ICU stay. Chi-Square and Multivariate Logistic Regression Test were used for data analysis. P.value less than ۰.۰۵ was considered significant. Data analysis was performed through SPSS version ۱۹.۰. Results: The incidence rate of VAP in the Ranitidine and Pantoprazole groups was ۴۴.۷% and ۳۷.۳% respectively (p=۰.۳). According to the multivariable logistic regression analysis, length of mechanical ventilation ≥ ۴ days was a predictive factor for VAP only in the Pantoprazole group (OR: ۱.۸, ۹۵% CI: ۱.۵۶-۱.۹۰, p=۰.۰۰۶). No relationship between GI bleeding incidence and stress ulcer prophylaxis was found (p=۰.۴). Kaplan-Meier curve showed no significant difference between the two groups of Ranitidine and Pantoprazole (p=۰.۴) in survival time according to the length of ICU stay. Conclusion: According to the results, there was no difference between the two groups in terms of VAP, GI bleeding and stress ulcer. Due to the lower cost of Ranitidine, it may be a more appropriate choice for GI bleeding prophylaxis in ICU patients.

Keywords:

VAP , Proton pump inhibitors , Histamine H۲ antagonists