• Kürşat Gündoğan, Emre Karakoc, Turgut Teke, Avşar Zerman, Aliye Esmaoglu, Şahin Temel, Muhammet Güven, and Murat Sungur.
• Division of Intensive Care, Department of Internal Medicine, Faculty of Medicine, Erciyes University, Kayseri, Turkey
• Turk J Med Sci. 2020 Jun 23; 50 (4): 776783776-783.

Background/AimCritically ill patients are at risk of developing gastrointestinal (GI) bleeding due to stress causing mucosal damage. Aim of the study was to determine the effect of oral/enteral nutrition with or without concomitant pantoprazole on upper GI bleeding in low risk critically ill patients.Materials And MethodsThis was a prospective, randomized, open-label, multicenter study conducted with intensive care unit (ICU) patients receiving oral/enteral nutritional support. Patients were randomly assigned into two groups including intervention group (received oral/EN plus pantoprazole) and control group (received only oral/EN).ResultsA total of 300 patients (intervention group: 152, control group: 148) participated in the study. Overall, 226 (75%) patients were fed by orally and 74 (25%) patients fed by enteral tube feeding. Median duration of nutritional support 4 (range: 2–33) days. Overt upper GI bleeding was noted only in one patient (0.65%) who was in the intervention group. The overall length of ICU stay of 4 (2–105) days, while ICU stay was significantly longer in the intervention group than in the control group (P = 0.006).ConclusionsOur findings seems to indicate that in patients who are at low risk for GI bleeding and under oral/enteral nutritional support, the use of PPIs may not reduce the risk of bleeding, however these results are imprecise because of low event (GI bleeding) rate and limited power.This work is licensed under a Creative Commons Attribution 4.0 International License.

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