The Effects Of Pantoprazole In The Prevention Of Gastrointestinal Bleeding In ICU Patients And Its Impact On Related Events:Meta Analysis

Objective: At present,the prevention of stress ulcer in critically ill patients in ICU is generally visible.However,the effect of proton pump inhibitors such as Pantoprazole is still controversial.Therefore,we performed this meta-analysis to assess the effect of pantoprazole on preventing adverse events such as gastrointestinal bleeding,mortality and infection in ICU patients,so as to reduce unnecessary risks and provide a reference for clinical use.Methods: Randomized controlled trials were reviewed.The retrieval time was limited from inception to November,2018.The retrieved databases included Embase,PubMed,the Cochrane Library,CBM,Web of Science,CNKI,the VIP database,and the Wan Fang database.Stata 12.0 software was used for data analysis.Results: Five randomized controlled trials,including4438 patients,were included.In these articles,2217 patients were in the Pantoprazole group and2221 patients were in the control group.There were 45 cases(2.03%)of gastrointestinal bleeding in pantoprazole group,81 cases(3.65%)of gastrointestinal bleeding in control group;344 cases(15.52%)of ventilator-associated pneumonia in pantoprazole group and 318 cases(14.32%)in control group.There were 591 cases(26.66%)of mortality in pantoprazole group and 567 cases(25.53%)in control group;and the average hospitalization time was 17.39 days in pantoprazole group and 15.885 days in control group.The meta-analysis showed that compared with control group,Pantoprazole group: 1)signifcantly reduced the incidence of Gastrointestinal bleeding(95% confdence interval [CI]: 0.39-0.80,RR=0.56);2)No signifcant difference was observed in terms of ventilator associated pneumonia events,mortality events and duration of hospitalization(95% CI: 0.93-2.47,95%CI: 0.94-1.14,95% CI:-0.04-0.44,respectively).Conclusion: Compared with control group,Pantoprazole can prevent the risk of gastrointestinal bleeding in patients with ICU in some degree,but it has no significant effect on mortality,ventilator-associated pneumonia and the duration of hospitalization events.