Comparison between intermittent and continuous intravenous proton pump inhibitors infusion in treatment of bleeding peptic ulcer

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Department of Hepatology, gastroenterology, and infectious diseases, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

Abstract

Background: Acute severe gastrointestinal (GI) bleeding is a prevalent global reason of mortality. Among the various etiologies, peptic ulcers are the most frequently encountered source of upper GI bleeding. Clinical guidelines advocate for the administration of intravenous proton pump inhibitors (PPIs) in individuals with bleeding ulcers exhibiting high-risk endoscopic characteristics, such as active bleeding, nonbleeding visible vessels, & adherent clots. This therapeutic approach involves an initial intravenous bolus dose followed by a continuous infusion of PPIs subsequent to endoscopic intervention. Aim and objectives: to measure the performance of intermittent intravenous PPI in treatment of peptic ulcer bleeding and compare it with continuous PPI infusion. Patients and methods: We performed a randomized single blinded controlled trial on patients who were presented with peptic ulcer bleeding at Al-Hussein and Bab El-sheria university hospitals in the period from January 2023 till June 2023. We enrolled 50 patients and were randomized into group I: continuous PPI and group II: intermittent PPI.Results: In our research group there were statistically significant differences among 2 groups in rebleeding, blood products administration, platelet transfusion favoring intermittent PPI group, ICU admission was significantly longer among continuous PPI group. Conclusion: intermittent intravenous PPI is comparable the current standard of care modalities in patients with PUB,but H pylori +ve patients responding to IV infusion much more than intermittent regimen.

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