[Experiences with the histamine-H2-receptor antagonist ranitidine in the prevention of stress ulcers].

The high incidence of gastrointestinal bleeding in critically ill patients requires an effective prevention of stress induced ulcers. For this reason the new developed histamine-H2-receptor blocker ranitidine was used in an open prospective study in 50 cases. The patients had been admitted in an intensive care unit because of respiratory insufficiency, combined with a number of additional risk factors (e.g. sepsis, peritonitis, head injury or renal failure). Despite a marked rise in mean gastric pH 4 of our 50 patients (8%) developed intermittent gastrointestinal bleeding, an operative intervention was not necessary. The bleeding patients had significant more risk factors. Though the number of cases is too small to draw definite conclusions, cytoprotective agents seem to be indicated too in high risk patients. Further trials are warranted.