Journal of Urban Health Research
Vol. 1 No. 1 (2022): Journal of Urban Health Research

Effectiveness of Proton Pump Inhibitors as a Gastrointestinal Bleeding Prophylaxis in Intensive Care Unit: Systematic Review and Meta-Analysis

Fonny Cokro (Department of Pharmacy, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia)
Jenny Jokimawidjaja (Unknown)



Article Info

Publish Date
01 Nov 2022

Abstract

Introduction: GI bleeding is a serious illness that can lengthen the time spent in the Intensive Care Unit (ICU) and increase morbidity and death by up to four times. Proton Pump Inhibitors (PPIs) are agents commonly used in patients to prevent Gastrointestinal (GI) bleeding in ICU. However, nowadays, the use of PPIs to prevent GI bleeding is being concerned due to the emergence of various studies regarding the side effects caused by PPIs. We conducted a systematic review and meta-analysis to see the magnitude of the effectiveness and validate the safety of PPIs. Methods: We searched through PubMed, ScienceDirect, GARUDA Portal, Clinical Key, and Google Scholar databases to identify randomized controlled trials (RCTs) that compared the effects of PPI administration on the PPI and placebo groups in adults ICU patients. Results: From a total of 8 studies, this meta-analysis shows the effectiveness of PPIs as prophylactic GI bleeding significantly with p < 0.0001, RR = 0.52 (95% CI 0.38-0.71). Regarding safety, PPIs did not significantly increase the risk of pneumonia (p = 0.30, RR = 1.31 (95% CI 0.78-2.20)); and C. difficile infection (p = 0.90, RR = 0.91 (95% CI 0.21-3.85); and it does not impact on the mortality event (p = 0.78; RR 1.01 (95% CI 0.93-1.10). Conclusions: PPIs reduce GI bleeding in ICU patients over the age of 18. PPIs are also safe to use as preventative GI bleeding with no increased risk of pneumonia and C. difficile infection. PPI does not, however, significantly affect the death rates.

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Journal Info

Abbrev

juhr

Publisher

Subject

Medicine & Pharmacology

Description

The journal open-access electronic journal. JUHR is a peer-reviewed journal. The journal aims to improve discussion and dissemination of knowledge in the fields of medicine, health, and pharmacy in order to improve the health outcomes of urban populations. JUHR accepts manuscripts written in English ...