TY - JOUR
T1 - High- versus low-dose proton pump inhibitors after endoscopic hemostasis in patients with peptic ulcer bleeding
T2 - A multicentre, randomized study
AU - Andriulli, Angelo
AU - Loperfido, Silvano
AU - Focareta, Rosaria
AU - Leo, Pietro
AU - Fornari, Fabio
AU - Garripoli, Antonietta
AU - Tonti, Paolo
AU - Peyre, Sergio
AU - Spadaccini, Antonio
AU - Marmo, Riccardo
AU - Merla, Antonio
AU - Caroli, Alessandro
AU - Forte, Gian Battista
AU - Belmonte, Angelo
AU - Aragona, Giovanni
AU - Imperiali, Gianni
AU - Forte, Fabrizio
AU - Monica, Fabio
AU - Caruso, Nazario
AU - Perri, Francesco
PY - 2008/12
Y1 - 2008/12
N2 - BACKGROUND: The most effective schedule of proton pump inhibitor (PPI) administration following endoscopic hemostasis of bleeding ulcers remains uncertain. METHODS: Patients with actively bleeding ulcers and those with nonbleeding visible vessel or adherent clot were treated with epinephrine injection and/or thermal coagulation, and randomized to receive intravenous PPIs according to an intensive regimen (80 mg bolus followed by 8 mg/h as continuous infusion for 72 h) or a standard regimen (40 mg bolus daily followed by saline infusion for 72 h). After the infusion, all patients were given 20 mg PPI twice daily orally. The primary end point was the in-hospital rebleeding rate, as ascertained at the repeat endoscopy. RESULTS: Bleeding recurred in 28 of 238 patients (11.8%) receiving the intensive regimen, and in 19 of 236 (8.1%) patients receiving the standard regimen (P = 0.18). Most rebleeding episodes occurred during the initial 72-h infusion: 18 (7.6%) and 19 events (8.1%) in the intensive and standard groups, respectively (P = 0.32). Mean units of blood transfused were 1.7 ± 2.1 in the intensive and 1.5 ± 2.1 in the standard regimen group (P = 0.34). The duration of hospital stay was
AB - BACKGROUND: The most effective schedule of proton pump inhibitor (PPI) administration following endoscopic hemostasis of bleeding ulcers remains uncertain. METHODS: Patients with actively bleeding ulcers and those with nonbleeding visible vessel or adherent clot were treated with epinephrine injection and/or thermal coagulation, and randomized to receive intravenous PPIs according to an intensive regimen (80 mg bolus followed by 8 mg/h as continuous infusion for 72 h) or a standard regimen (40 mg bolus daily followed by saline infusion for 72 h). After the infusion, all patients were given 20 mg PPI twice daily orally. The primary end point was the in-hospital rebleeding rate, as ascertained at the repeat endoscopy. RESULTS: Bleeding recurred in 28 of 238 patients (11.8%) receiving the intensive regimen, and in 19 of 236 (8.1%) patients receiving the standard regimen (P = 0.18). Most rebleeding episodes occurred during the initial 72-h infusion: 18 (7.6%) and 19 events (8.1%) in the intensive and standard groups, respectively (P = 0.32). Mean units of blood transfused were 1.7 ± 2.1 in the intensive and 1.5 ± 2.1 in the standard regimen group (P = 0.34). The duration of hospital stay was
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U2 - 10.1111/j.1572-0241.2008.02149.x
DO - 10.1111/j.1572-0241.2008.02149.x
M3 - Article
C2 - 19086953
AN - SCOPUS:58149384462
VL - 103
SP - 3011
EP - 3018
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
SN - 0002-9270
IS - 12
ER -