A Comparison between the Impacts of Continuous and Intermittent Intravenous Pantoprazole Injection on High Risk Upper Gastrointestinal Bleeding

Background & Objective:  Although higher age was previously associated with upper gastrointestinal bleeding (UGIB), rebleeding due to low PH has been recently considered as a crucial prognosis factor. In this regard, pantoprazole, a Proton pump inhibitor (PPIs), along with endoscopy was applied in high-risk patients. As it is an undeniably momentous approach to discover the best PPIs injection method, the advantages and disadvantages of continuous and intermittent PPIs’ infusion were compared in high-risk UGIBs patients. Materials & Methods: Eighty selected patients were randomly divided into two equal groups. In the continuous infusion, there were ۶ and ۳۴ patients with adherent clot ulcers and visible vessel ulcers without bleeding; however, ۲ and ۳۸ patients with these ulcers were present in the intermittent infusion group in turn. After three days, ulcers, packed cells, and surgery needs were evaluated between the two groups.  Results: After ۷۲ hours of treatment, ۲۹, ۳ and ۸ patients in the continuous group showed clean base, flat pigmented spot, and visible vessel ulcer with bleeding, respectively. Whereas in the intermittent group, these records were ۳۵, ۵ and ۰, respectively (p≤۰.۰۲۸). The number of patients in the continuous infusion group with a visible vessel ulcer was significantly higher (p>۰.۰۲۸). A significant difference was also observed between the groups in terms of length of hospitalizations (p≤۰.۰۰۱) with no mortality.  Conclusion: Based on the findings, the intermittent infusion of PPIs is obviously superior over continuous mode. However, further studies with a larger population are recommended to discover the merits and drawbacks of this method in high-risk UGIBs.

کلیدواژه ها:

Upper gastrointestinal bleeding ، Proton pump inhibitors ، Continuous infusion ، Intermittent