Omeprozole therapy in pediatric patients after liver and intestinal transplantation

Stuart S. Kaufman, Elizabeth Ruby Lyden, Cindy R. Brown, Carolyn K. Davis, Deborah A. Andersen, Keith M. Olsen, Kimberly L. Bergman, Simon P. Horslen, Debra L. Sudan, Ira J. Fox, Byers W. Shaw, Alan N. Langnas

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Background: Proton pump inhibitors such as omeprazole are increasingly used to prevent stress-related gastric bleeding in critically ill patients. In this investigation, the acid-suppressive potency of omeprazole was assessed in one at-risk group, pediatric patients undergoing liver or intestinal transplantation, or both. Methods: Twenty-two patients ranging in age from 0.9 to 108 months (23.8 ± 6.5) underwent isolated liver (n = 10) or intestinal (11 with composite liver allografts) transplantation. Omeprazole was delivered in bicarbonate suspension through a nasogastric tube. Therapy was started after surgery at 0.5 mg/kg every 12 hours. Gastric pH monitoring was performed approximately 2 days later. Results: For the entire group, mean gastric pH equaled 6.1 ± 0.3, the same in recipients of isolated liver and intestinal allo-grafts. Twelve of the 22 patients demonstrated a discontinuous omeprazole effect, that is, dissipation of acid reduction before the next dose. Five of the 12 patients with discontinuous omeprazole effect had mean gastric pH of less than 5 (3.9 ± 0.4). In 4 of these 5, the omeprazole dosing interval was shortened to every 8 or every 6 hours, resulting in an increase in mean pH to 6.6 ± 0.2 (P < 0.01). In the remaining 10 of 22 patients, acid suppression was uninterrupted until the next dose. No patient experienced bleeding attributable to gastric erosion. Conclusion: Omeprazole suspended in sodium bicarbonate is an effective acid-suppressing agent in pediatric recipients of liver or intestinal transplant, or both. A dosage of 0.5 mg/kg every 12 hours is sufficient for most patients, but dosing every 6 to 8 hours is required to assure maximal acid suppression in all.

Original languageEnglish (US)
Pages (from-to)194-198
Number of pages5
JournalJournal of pediatric gastroenterology and nutrition
Volume34
Issue number2
DOIs
StatePublished - Apr 9 2002

Keywords

  • Children
  • Infants
  • Intestinal transplant
  • Liver transplant
  • Omeprozole
  • Stress ulcer

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology

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  • Cite this

    Kaufman, S. S., Lyden, E. R., Brown, C. R., Davis, C. K., Andersen, D. A., Olsen, K. M., Bergman, K. L., Horslen, S. P., Sudan, D. L., Fox, I. J., Shaw, B. W., & Langnas, A. N. (2002). Omeprozole therapy in pediatric patients after liver and intestinal transplantation. Journal of pediatric gastroenterology and nutrition, 34(2), 194-198. https://doi.org/10.1097/00005176-200202000-00016