SIDE EFFECTS OF PROTON PUMP INHIBITORS IN THE CASE OF THEIR ROUTINE USE IN INTENSIVE CARE UNITS.

Authors

DOI:

https://doi.org/10.11603/2414-4533.2024.2.14856

Keywords:

proton pump inhibitors, severe brain injury

Abstract

The aim of the work - to compare the incidence of nosocomial pneumonia, acute kidney injury and diarrhea caused by Clostridium difficile in patients with severe head injury and sepsis depending on the use of omeprazole.

Materials and Methods.  200 patients with severe TBI who were on prolonged mechanical ventilation were examined. Half of them received proton pump inhibitors, the other half did not.

The primary endpoints of the study (serious adverse events) were: • 28-day mortality, and • frequency of gastrointestinal bleeding during the study.

Secondary endpoints of the study (adverse events) were: • frequency of acute kidney injury, • frequency of diarrhea caused by confirmed Clostridium difficile infection, • incidence of ventilator-associated pneumonia.

Results. Prophylactic use of omeprazole in the routine treatment of sepsis after surgery for severe head injury increases the likelihood of ventilator-associated pneumonia, acute kidney injury, and clostridial infection, which may be the cause of increased mortality.

References

Seymour CW, Liu VX, Iwashyna TJ, et. al. Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016; 315(8):762-74. DOI: 10.1001/jama.2016.0288.

Strand DS, Kim D, Peura DA. 25 Years of proton pump inhibitors: a comprehensive review. Gut Liver. 2017 Jan; 11(1): 27–37. Published online 2016 Nov 14. DOI: 10.5009/gnl15502.

Ahmed A, Clarke J. Proton Pump Inhibitors, StatPearls 2023. An official website of the United States government. Last Update: May 1, 2023. https://www.ncbi.nlm.nih.gov/books/NBK557385/.

Baiardi G, Mattioli F, et al. Deprescribing Strategies: A prospective study on proton pump inhibitors. J Clin Med. 2023; 12(8):3029. DOI: 10.3390/jcm12083029.

Kinoshita Y, Ishimura N, Ishihara S. Advantages and disadvantages of long-term proton pump inhibitor use. J Neurogastroenterol Motil. 2018; 24(2):182-196. DOI: 10.5056/jnm18001.

He N, Yan Y, Su S, et al. Are proton pump inhibitors more effective than histamine-2-receptor antagonists for stress ulcer prophylaxis in critically ill patients? a systematic review and meta-analysis of cohort studies. Ann Pharmacother. 2022; 56(9):988-997. DOI: 10.1177/10600280211059040.

Dharmarajan TS. The use and misuse of proton pump inhibitors: an opportunity for deprescribing. J Am Med Dir Assoc. 2021; 22(1):15-22. DOI: 10.1016/j.jamda.2020.09.046.

Evaluation of the Disability Determination Process for Traumatic Brain Injury in Veterans. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Care Services; Committee on the Review of the Department of Veterans Affairs Examinations for Traumatic Brain Injury. Washington (DC): National Academies Press (US); 2019 Apr 10. PMID: 31211534 Bookshelf ID: NBK542602 DOI: 10.17226/25317 https://www.ncbi.nlm.nih.gov/books/NBK542602/

Kukla M, Adrych K, Dobrowolska A. Guidelines for Clostridium difficile infection in adults. Prz Gastroenterol. 2020;15(1):1-21. DOI: 10.5114/pg.2020.93629. Epub 2020 Mar 19.

Kim, BS, Li, BT, Engel, A. Diagnosis of gastrointestinal bleeding: A practical guide for clinicians. World J Gastrointest Pathophysiol. 2014; 5(4): 467–478. Published online 2014 Nov 15. DOI: 10.4291/wjgp.v5.i4.467.

Carney N, Totten AM, O'Reilly C, et al: Guidelines for the management of severe traumatic brain injury, fourth edition. Neurosurgery. 2017; 80(1):6-15. DOI: 10.1227/NEU.0000000000001432.

Ghebremariam YT, Cooke JP, Gerhart W, et al. Pleiotropic effect of the proton pump inhibitor esomeprazole leading to suppression of lung inflammation and fibrosis. J Transl Med. 2015; 13:249. DOI: 10.1186/s12967-015-0614-x.

Li Z, Wu C, Li L, et al. Effect of long-term proton pump inhibitor administration on gastric mucosal atrophy: A meta-analysis. Saudi J Gastroenterol. 2017; 23(4):222-228. DOI: 10.4103/sjg.SJG_573_16.

Strand DS, Kim D, Peura DA. 25 Years of proton pump inhibitors: a comprehensive review. Gut Liver. 2017; 11(1):27-37. DOI: 10.5009/gnl15502.

Brunner G, Athmann C, Schneider A. Long-term, open-label trial: safety and efficacy of continuous maintenance treatment with pantoprazole for up to 15 years in severe acid-peptic disease. Aliment Pharmacol Ther. 2012; 36(1):37-47. DOI: 10.1111/j.1365-2036.2012.05106.x.

Deliwala SS, Hamid K, Goyal H, et al. Proton pump inhibitors versus histamine-2-receptor antagonists for stress ulcer prophylaxis in critically ill patients: a meta-analysis and trial sequential analysis. J Clin Gastroenterol. 2022; 56(3):204-217. DOI: 10.1097/MCG.0000000000001562.

Reynolds PM, MacLaren R. Re-evaluating the utility of stress ulcer prophylaxis in the critically ill patient: a clinical scenario-based meta-analysis. Pharmacotherapy. 2019; 39(3):408-420. DOI: 10.1002/phar.2172.

Alshamsi F, Belley-Cote E, Cook D, et al. Efficacy and safety of proton pump inhibitors for stress ulcer prophylaxis in critically ill patients: a systematic review and meta-analysis of randomized trials. Crit Care. 2016; 20(1):120. DOI: 10.1186/s13054-016-1305-6.

Wang Y, Ge L, Ye Z, et al. Efficacy and safety of gastrointestinal bleeding prophylaxis in critically ill patients: an updated systematic review and network meta-analysis of randomized trials. Intensive Care Med. 2020; 46(11): 1987-2000. DOI: 10.1007/s00134-020-06209-w.

Boyd C, Hassig T, MacLaren R. A pragmatic assessment of proton pump inhibitors vs. histamine type 2 receptor antagonists on clinically important gastrointestinal bleeding and mortality when used for stress ulcer prophylaxis in the ICU. Pharmacotherapy. 2021; 41(10):820-827. DOI: 10.1002/phar.2621.

Kumar S, Ramos C, Garcia-Carrasquillo RJ, et al. Incidence and risk factors for gastrointestinal bleeding among patients admitted to medical intensive care units. Frontline Gastroenterol. 2017; 8(3):167-173. DOI: 10.1136/flgastro-2016-100722.

Chu YF, Jiang Y, Meng M, et al. Incidence and risk factors of gastrointestinal bleeding in mechanically ventilated patients. World J Emerg Med. 2010; 1(1):32-6. PMC4129768.

Nochaiwong S, Ruengorn C, Awiphan et al. The association between proton pump inhibitor use and the risk of adverse kidney outcomes: a systematic review and meta-analysis. Nephrol Dial Transplant. 2018; 33(2):331-342. DOI: 10.1093/ndt/gfw470.

Sanchez-Alamo B, Cases-Corona C, Fernandez-Juarez G. Facing the Challenge of Drug-Induced Acute Interstitial Nephritis. Nephron. 2023; 147(2):78-90. DOI: 10.1159/000525561. Epub 2022 Jul 13.

Hoste EA, Schurgers M. Epidemiology of acute kidney injury: how big is the problem? Crit Care Med. 2008; 36(4 Suppl):S146-51. DOI: 10.1097/CCM.0b013e318168c590.

Fontecha-Barriuso M, Martín-Sanchez D, Martinez-Moreno JM, et al. Molecular pathways driving omeprazole nephrotoxicity. Redox Biol. 2020; 32:101464. DOI: 10.1016/j.redox.2020.101464.

Koh HB, Joo YS, Kim HW, Jo W, Chan Kang S, Jhee JH, Han M, Lee M, Han SH, Yoo TH, Kang SW, Park JT. Association between proton pump inhibitor exposure and acute kidney injury after cardiac surgery. Mayo Clin Proc. 2023; 98(2):266-277. DOI: 10.1016/j.mayocp.2022.07.024. PMID: 36737115.

Elliott B, Androga GO, Knight DR, Riley TV. Clostridium difficile infection: evolution, phylogeny and molecular epidemiology. Infect Genet Evol. 2017; 49:1-11. DOI: 10.1016/j.meegid.2016.12.018. Epub 2016 Dec 22.

Bavishi C, Dupont HL. Systematic review: the use of proton pump inhibitors and increased susceptibility to enteric infection. Aliment Pharmacol Ther. 2011; 34(11-12):1269-81. DOI: 10.1111/j.1365-2036.2011.04874.x. Epub 2011 Oct 17.

Reveles KR, Ryan CN, Chan L, et al. Proton pump inhibitor use associated with changes in gut microbiota composition. Gut. 2018; 67(7):1369-1370. DOI: 10.1136/gutjnl-2017-315306.

Samarkos M, Mastrogianni E, Kampouropoulou O. The role of gut microbiota in Clostridium difficile infection. Eur J Intern Med. 2018; 50:28-32. DOI: 10.1016/j.ejim.2018.02.006.

Lin CY, Cheng HT, Kuo CJ, et al. Proton pump inhibitor-induced gut dysbiosis increases mortality rates for patients with clostridioides difficile infection. Microbiol Spectr. 2022; 10(4):e0048622. DOI: 10.1128/spectrum.00486-22

Hegarty JP, Sangster W, Harris LR 3rd, Stewart DB. Proton pump inhibitors induce changes in colonocyte gene expression that may affect Clostridium difficile infection. Surgery. 2014; 156(4):972-8. DOI: 10.1016/j.surg.2014.06.074.

Spalding MC, Cripps MW, Minshall CT. Ventilator-Associated Pneumonia: New Definitions. Crit Care Clin. 2017; 33(2):277-292. DOI: 10.1016/j.ccc.2016.12.009.

Buendgens L, Bruensing J, Matthes M, et al. Administration of proton pump inhibitors in critically ill medical patients is associated with increased risk of developing Clostridioides difficile-associated diarrhea. J Crit Care. 2014; 29(4):696.e11-5. DOI: 10.1016/j.jcrc.2014.03.002.

Zhou X, Fang H, Xu J, et al. Stress ulcer prophylaxis with proton pump inhibitors or histamine 2 receptor antagonists in critically ill adults - a meta-analysis of randomized controlled trials with trial sequential analysis. BMC Gastroenterol. 2019; 19(1):193. DOI: 10.1186/s12876-019-1105-y.

Ran L, Khatibi NH, Qin X, Zhang JH. Proton pump inhibitor prophylaxis increases the risk of nosocomial pneumonia in patients with an intracerebral hemorrhagic stroke. Acta Neurochir Suppl. 2011; 111:435-9. DOI: 10.1007/978-3-7091-0693-8_75. PMID: 21725797.

Arai N, Nakamizo T, Ihara H, et al. Histamine H2-Blocker and proton pump inhibitor use and the risk of pneumonia in acute stroke: a retrospective analysis on susceptible patients. PLoS One. 2017; 12(1):e0169300. DOI: 10.1371/journal.pone.0169300.

Published

2024-06-28

How to Cite

OLIYNYK, O. V. (2024). SIDE EFFECTS OF PROTON PUMP INHIBITORS IN THE CASE OF THEIR ROUTINE USE IN INTENSIVE CARE UNITS. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (2), 132–142. https://doi.org/10.11603/2414-4533.2024.2.14856

Issue

Section

EXPERIENCE OF WORK