الفهرس 
Functional Anatomy of the StomachOnly 14 pages are availabe for public view
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Abstract
Purpose:
To clinically evaluate and statistically compare the efficacy of proton pump inhibitors versus histamine-2 receptor blockers in the prevention of stress ulcer in mechanically ventilated patients.
Data sources:
PubMed database until 2016.
Study selection:
A controlled Randomized study of proton pump inhibitors ( pantoprazole) versus histamine-2 receptor antagonists.
Outcomes Evaluated:
Primary outcomes: decreasing overt bleeding, increasing the gastric pH, and decreasing the gastric juice volume.
Secondary outcomes: incidence of associated pneumonia and clostridium difficile infection.
Data Synthesis:
One hundred and two patients were enrolled in the study, they are divided randomly into two groups each of 51 patients.
The gastric juice volume was decreased more with the use of PPIs as compared to H2RAs. After 2 hour of PPIs administration the juice volume decreased from 66.32 mL to 36.72 mL and this decrease continued to occur over the later hours as it reached 15.30 mL after 6 hours. While with the use of H2RAs the volume was decreased from 74.12 mL to just 67.66 mL 2 hours after the administration.
Gastric pH was measured at different time intervals (2,4,6 hours) it showed an increase of the gastric pH to be more alkaline with the use of PPIs as compared to H2RAs, as it becomes (6) after 2 hours of PPIs administration compared to being (5) after 2 hours of H2RAs adminstration.
Decreasing of GI bleeding, revealed that there is a decrease in incidence of GI bleeding by 1.96% and 9.8% with the use of PPIs and H2RAs, repectively.
The secondary outcomes was measured ehich demonstrates that both PPIs and H2RAs are associated with a risk of clostridium difficile infection by percentage of 7.84% with PPIs and 1.96% with H2RAs. While pneumonia infection is highly associated with PPIs by 39.22% compared to H2RAs 27.45%.
Conclusion:
PPIs are superior to histamine 2 receptor antagonists in prevention of stress ulcer in mechanically ventilated critically ill patients. Also they are associated with greater risk of pneumonia and Clostridium difficile infection compared with H2RAs.