Objective: To determine the dosing regimen of intravenous ranitidine (IVR) most likely to achieve a gastric pH of ≥4 in critically ill pediatric patients.
Methods: A retrospective cohort study was designed and included patients younger than 19 years with gastric pH samples taken from a nasogastric tube within 24 hours after a dose of IVR in an intensive care unit. Data collection included patient demographics, clinical variables, IVR dosing, and gastric pH samples. Descriptive statistical analysis and multivariable logistic regression analysis with clustering of patients was performed to determine variables associated with odds of obtaining a pH of ≥4.
Results: A total of 628 patients (1356 nasogastric samples) met study criteria (median age 1.3 years [IQR, 0.33, 5.7 years]; 53% male). The IVR dose was 0.90 ± 0.30 mg/kg per dose every 8.1 ± 2.9 hours, and 60.9% of patients (n = 383) had a pH ≥4. Patients with a pH value ≥4 had gastric pH samples taken earlier after a dose of IVR (6.7 ± 5.0 vs. 5.9 ± 4.7 hours, p < 0.001) but had no difference in IVR dose per kilogram (0.88 ± 0.31 vs. 0.88 ± 0.26, p = 0.86) or frequency of dosing (7.9 ± 3.2 vs. 7.9 ± 3.2 hours, p = 0.89). A multivariable logistic regression model identified increasing age, decreased kidney function, and decreased time to pH sample after an IVR dose with significantly greater odds of pH ≥4.
Conclusions: The IVR dosing to maintain a gastric pH ≥4 in critically ill pediatric patients should occur more frequently than every 8 hours. Gastric pH evaluation may be necessary to assess IVR efficacy.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836694 | PMC |
http://dx.doi.org/10.5863/1551-6776-24.6.504 | DOI Listing |
Front Cell Infect Microbiol
December 2024
Medical Laboratory, Kunming Children's Hospital, Children's Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China.
Sepsis is a systemic inflammatory response syndrome of multiorgan failure caused by dysregulation of the host response to infection and is a major cause of death in critically ill patients. In recent years, with the continuous development of sequencing technology, the intestinal microecology of this disease has been increasingly studied. The gut microbiota plays a host-protective role mainly through the maintenance of normal immune function and the intestinal barrier.
View Article and Find Full Text PDFMed Sci Monit
December 2024
Department of Paediatric Intensive Care, Emma Children's Hospital, Amsterdam UMC, Meibergdreef, Netherlands.
BACKGROUND Patient monitoring systems (PMSs) are essential for monitoring and managing the condition of critically ill patients. In low-resource settings, limited access to technology, low-level digital literacy, and power outage challenges are usability concerns. The main aim of this study was to evaluate the usability of the IMPALA (Innovative Monitoring in Paediatrics in Low-resource settings: an Aid to save lives) PMS optimized for use in low-resource settings by assessing the opinions and experiences of 24 healthcare professionals.
View Article and Find Full Text PDFBMC Infect Dis
December 2024
Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
Background: The World Health Organization (WHO) has identified carbapenem-resistant Pseudomonas aeruginosa (CRPA) as one of the three critical priority pathogens. There is scarce literature evaluating the treatment outcomes in patients with CRPA infections treated with traditional non-carbapenem β-lactam (NCBL) agents. Thus, this study aims to assess the effectiveness of traditional NCBL compared to novel β-lactam agents (NVL) for treating non-carbapenem β-lactam -susceptible CRPA.
View Article and Find Full Text PDFAPMIS
January 2025
Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Colistin is a last-resort treatment for multidrug-resistant Gram-negative bacterial infections, particularly in critically ill patients. Nevertheless, it remains a major threat to public health. We assessed the proportion of colistin-resistant Gram-negative isolates from intensive care unit (ICU) infections in different years, areas, pathogens, and antimicrobial susceptibility tests (AST).
View Article and Find Full Text PDFJ Food Prot
December 2024
Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention. 1600 Clifton Rd NE MS-H24-10, Atlanta, GA 30333, USA. Electronic address:
Listeria monocytogenes causes listeriosis, a serious infection, with a high mortality rate for persons at higher risk for listeriosis. The first Listeria outbreak linked to frozen vegetables occurred in 2016 and resulted in three deaths. Many frozen vegetables are intended to be consumed after cooking.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!