A PROSPECTIVE-STUDY OF OMEPRAZOLE SUSPENSION TO PREVENT CLINICALLY SIGNIFICANT GASTROINTESTINAL-BLEEDING FROM STRESS-ULCERS IN MECHANICALLYVENTILATED TRAUMA PATIENTS

Objective: To prospectively evaluate the incidence of clinically signi ficant bleeding, side effects, and cost of therapy in mechanically ven tilated trauma patients at high risk for stress ulcers who received si mplified omeprazole suspension (SOS). Methods: Prospective, evaluative study in a Level I trauma center. Mechanically ventilated trauma pati ents admitted with at least one additional risk factor for stress ulce r development received SOS for stress ulcer prophylaxis. Results: Sixt y trauma patients were enrolled. The mean Injury Severity Score was 27 .3. After starting SOS, there were no cases of clinically significant upper gastrointestinal bleeding related to stress ulceration. Baseline pH was 3.3, and mean gastric pH after SOS was increased to 6.7 (p < 0 .005). There were no adverse effects thought to be related to omeprazo le suspension. Incidence of nosocomial pneumonia after beginning SOS w as 28.3%. The cost of acquisition plus administration of SOS was $13.1 3 per day, whereas the cost of drug acquisition alone was $3.83 per da y. Conclusion: In a prospective, evaluative study of 60 trauma patient s who required mechanical ventilation and had at least one additional risk factor for stress ulcer development, omeprazole suspension preven ted clinically significant gastrointestinal bleeding, maintained excel lent control of gastric pH, produced no toxicity, and was the least co stly medication alternative.