| アブストラクト | PURPOSE: Patients receiving extracorporeal membrane oxygenation (ECMO) generally receive proton pump inhibitors (PPIs) or histamine-2 receptor antagonists (H2RAs) to avoid major gastrointestinal bleeding. Our aim was to compare outcomes between patients receiving PPIs and H2RAs for stress ulcer prophylaxis during ECMO. MATERIALS AND METHODS: We performed a retrospective cohort study using the Japanese Diagnosis Procedure Combination Database, using data recorded from 1 July 2010 to 31 March 2017. We defined patients who received PPIs within 2 days after starting ECMO as the PPIs group and those who received H2RAs within 2 days after starting ECMO as the H2RAs group. We performed propensity score matching to compare outcomes. The primary outcomes were gastrointestinal bleeding requiring endoscopic haemostasis and in-hospital mortality. The secondary outcomes were red blood cell transfusion, hospital-acquired pneumonia and Clostridium difficile infection during hospitalisation. RESULTS: Of 11 328 eligible patients, 9738 received PPIs and 1590 received H2RAs. Propensity score matching created 1556 pairs. No significant differences were seen regarding endoscopic haemostasis (1.2% vs 0.8%; p=0.37), in-hospital mortality (53.0% vs 53.1%; p=0.94), red blood cell transfusion rates (91.4% vs 89.7%; p=0.11), hospital-acquired pneumonia (13.0% vs 12.4%; p=0.59) or C. difficile infection (0.1% vs 0.2%; p=0.32) between the PPIs and H2RAs groups, respectively. CONCLUSION: We found no differences in the evaluated outcomes between the PPIs and H2RAs groups. Both PPIs and H2RAs are treatment options for stress ulcer prophylaxis in patients undergoing ECMO. |
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| ジャーナル名 | BMJ open |
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| 投稿日 | 2020/10/1 |
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| 投稿者 | Kondo, Yutaka; Ohbe, Hiroyuki; Matsui, Hiroki; Fushimi, Kiyohide; Tanaka, Hiroshi; Yasunaga, Hideo |
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| 組織名 | Department of Emergency and Critical Care Medicine, Juntendo University Urayasu;Hospital, Urayasu, Chiba, Japan kondokondou2000@yahoo.co.jp.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Health Care Policy and Informatics, Tokyo Medical and Dental University, Tokyo,;Japan.;Hospital, Urayasu, Chiba, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/32994240/ |
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