• Hongli He, Shuling Hu, Qihong Chen, Ling Liu, Yingzi Huang, Yi Yang, and Haibo Qiu.
• Department of Critical Care Medicine, Affiliated Zhong-Da Hospital of Southeast University, Nanjing 210009, China.
• Zhonghua Nei Ke Za Zhi. 2014 Jan 1;53(1):48-54.

ObjectiveTo evaluate the effect of sucralfate and acid-suppressive drugs on preventing ventilator-associated pneumonia (VAP) in mechanically ventilated patients.MethodsAll randomized controlled trials (RCTs), which studied the effect of sucralfate and acid-suppressive drugs on the incidence of VAP in mechanically ventilated patients, were searched from PubMed, Embase and the Cochrane Library during January 1966 to March 2013 via manual and computer retrieval. All related data were extracted. Meta analysis was conducted using the statistical software RevMan 5.2 and the quality of the RCTs was strictly evaluated with the methods recommended by the Cochrane Collaboration.ResultsA total of 15 RCTs involving 1315 patients in the sucralfate group and 1568 patients in the acid-suppressive drug group were included in this study. The incidence of VAP was significantly reduced in the sucralfate group (RR = 0.81, 95%CI 0.7-0.95, P = 0.008), while no difference was found between the two groups in the incidence of stress-related gastrointestinal bleeding (RR = 0.96, 95%CI 0.59-1.58, P = 0.88). No statistical difference was found in the days on ventilator, duration of ICU stay and ICU mortality in the two groups (all P values > 0.05).ConclusionIn patients with mechanical ventilation, sucralfate could decrease the incidence of VAP, while has no such effect on the stress-related gastrointestinal bleeding, the days on ventilator, duration of ICU stay and ICU mortality.

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