THERAPEUTIC APPROACHES FOR ACID REDUCTION IN PATIENTS ADMITTED TO INTENSIVE CARE UNITS WITH A HISTORY OF GASTROESOPHAGEAL REFLUX DISEASE AT A TERTIARY CARE HOSPITAL IN PAKISTAN.
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Keywords
Gastroesophageal reflux disease, Proton pump inhibitors, GERD in ICU, new antacids
Abstract
Introduction: Although the prevalence of gastroesophageal reflux disease (GERD) in intensive care units is still unknown, the condition is on the rise all over the world. Patients in critical condition are especially susceptible to gastroesophageal reflux disease (GERD) because of the many procedures and underlying illnesses they undergo. Pepsin levels in oral secretions, ambulatory monitoring, and pH measurement are among procedures that can be utilized in the diagnostic process. The most popular treatment methods consist of adjusting one's lifestyle and using medicine, mainly proton pump inhibitors (PPIs).
Methodology: An analysis of data collected from 96 critically sick patients who were getting acid-lowering medication was carried out in retrospective research that was carried out at a tertiary care hospital in AJK, Pakistan between June and December 2023.
Results: Most patients were being treated in medical intensive care units (MICU), and the medications that were prescribed the most frequently were omeprazole and esomeprazole. Omeprazole and antacids were the primary maintenance medications that were administered at the time of discharge. Patients who were diagnosed with gastroesophageal reflux disease (GERD) and those who were undergoing mechanical ventilation made up a sizeable share, with most of them receiving intravenous proton pump inhibitors (PPIs). Both potassium-competitive acid blockers and omeprazole were shown to have equivalent levels of treatment efficacy, according to the findings.
Conclusion: Most of trials in past have established esomeprazole being highlighted as having superiority in certain studies. On the other hand, newer possibilities such as GABA-B agonist baclofen and P-CABs offer potential lines of investigation. Even though developing medicines require more exploration for routine management, intravenous proton pump inhibitors (PPIs) continue to be the primary emergency treatment for gastroesophageal reflux disease (GERD) in critical care.
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Dara Jamali
MBBS, Post Graduate Trainee, Ziauddin University Hospital Karachi, Pakistan
Fasiha Mazhar
Associate Professor, Ziauddin University Hospital Karachi , Pakistan
Arzu Jadoon
MBBS, Post Graduate Trainee, Ziauddin University Hospital Karachi, Pakistan