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 language | English (US) |
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Pages (from-to) | 194-198 |
Number of pages | 5 |
Journal | Journal of pediatric gastroenterology and nutrition |
Volume | 34 |
Issue number | 2 |
DOIs | |
State | Published - 2002 |
Keywords
- Children
- Infants
- Intestinal transplant
- Liver transplant
- Omeprozole
- Stress ulcer
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Gastroenterology