Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Pantoprazole in Patients at Risk for Gastrointestinal Bleeding in the ICU

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Variant PNLDC1, Defective piRNA Processing, and Azoospermia

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Lower or Higher Oxygenation Targets for Acute Hypoxemic Respiratory Failure

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. A Placebo-Controlled Trial of Subcutaneous Semaglutide in Nonalcoholic Steatohepatitis

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Monoclonal Antibody for Patients with Covid-19. Reply

    Research output: Contribution to journalLetterResearchpeer-review

  1. Handling oxygenation targets in ICU patients with COVID-19-Protocol and statistical analysis plan in the HOT-COVID trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Low-dose hydrocortisone in patients with COVID-19 and severe hypoxia: the COVID STEROID randomised, placebo-controlled trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Use of crystalloids and colloids in Europe per year from 2010 to 2019: Protocol for an international descriptive study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Altered brown fat thermoregulation and enhanced cold-induced thermogenesis in young, healthy, winter-swimming men

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND: Prophylaxis for gastrointestinal stress ulceration is frequently given to patients in the intensive care unit (ICU), but its risks and benefits are unclear.

METHODS: In this European, multicenter, parallel-group, blinded trial, we randomly assigned adults who had been admitted to the ICU for an acute condition (i.e., an unplanned admission) and who were at risk for gastrointestinal bleeding to receive 40 mg of intravenous pantoprazole (a proton-pump inhibitor) or placebo daily during the ICU stay. The primary outcome was death by 90 days after randomization.

RESULTS: A total of 3298 patients were enrolled; 1645 were randomly assigned to the pantoprazole group and 1653 to the placebo group. Data on the primary outcome were available for 3282 patients (99.5%). At 90 days, 510 patients (31.1%) in the pantoprazole group and 499 (30.4%) in the placebo group had died (relative risk, 1.02; 95% confidence interval [CI], 0.91 to 1.13; P=0.76). During the ICU stay, at least one clinically important event (a composite of clinically important gastrointestinal bleeding, pneumonia, Clostridium difficile infection, or myocardial ischemia) had occurred in 21.9% of patients assigned to pantoprazole and 22.6% of those assigned to placebo (relative risk, 0.96; 95% CI, 0.83 to 1.11). In the pantoprazole group, 2.5% of patients had clinically important gastrointestinal bleeding, as compared with 4.2% in the placebo group. The number of patients with infections or serious adverse reactions and the percentage of days alive without life support within 90 days were similar in the two groups.

CONCLUSIONS: Among adult patients in the ICU who were at risk for gastrointestinal bleeding, mortality at 90 days and the number of clinically important events were similar in those assigned to pantoprazole and those assigned to placebo. (Funded by Innovation Fund Denmark and others; SUP-ICU ClinicalTrials.gov number, NCT02467621 .).

Original languageEnglish
JournalThe New England journal of medicine
Volume379
Issue number23
Pages (from-to)2199-2208
ISSN0028-4793
DOIs
Publication statusPublished - 2018

ID: 55539124