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Comparative analysis of the effect of IV administered acid suppressants on gastric pH in dogs.
Journal of Veterinary Internal Medicine ( IF 2.1 ) Pub Date : 2020-02-05 , DOI: 10.1111/jvim.15718
Amanda Kuhl 1 , Adesola Odunayo 1 , Josh Price 1 , Silke Hecht 1 , Kristen Marshall 1 , Joerg Steiner 2 , M Katherine Tolbert 2
Affiliation  

BACKGROUND Upper gastrointestinal (GI) ulceration and bleeding in critically ill dogs can cause severe anemia and increase morbidity. Acid suppressants using proton pump inhibitors or histamine-2 receptor blockers administered IV is commonly recommended. HYPOTHESIS/OBJECTIVES To evaluate the efficacy of IV administered esomeprazole, pantoprazole, and famotidine constant rate infusion (CRI) on increasing the intragastric pH of dogs. We hypothesized that esomeprazole and famotidine CRI would provide superior acid suppression compared to pantoprazole and reach pH goals for the treatment of GI bleeding. ANIMALS Nine healthy research Beagles. METHODS Randomized, 3-way crossover. Dogs received pantoprazole or esomeprazole at 1 mg/kg IV q12h and famotidine with a loading dose of 1 mg/kg followed by 8 mg/kg IV CRI daily for 3 consecutive days. The intragastric pH was recorded at baseline and for 72 hours of treatment. The mean pH and the mean percentage time (MPT) the intragastric pH was ≥3 or ≥4 were compared among and within treatment groups. RESULTS Significant increases in mean pH (P < 0.0001), MPT ≥3 (P < 0.001), and MPT ≥4 (P = 0.0006) were noted over time with all 3 treatments. The time effect did not differ by treatment for mean pH, MPT ≥3, and MPT ≥4 (P = .29, .56, and .37, respectively); however, only esomeprazole and famotidine CRI achieved the goals established for the treatment of gastroduodenal ulceration in people. CONCLUSIONS AND CLINICAL IMPORTANCE Famotidine CRI and esomeprazole might be superior acid suppressants compared to standard doses of pantoprazole for the first 72 hours of treatment.

中文翻译:

静脉注射酸抑制剂对犬胃pH值影响的比较分析。

背景技术危重犬的上消化道(GI)溃疡和出血可导致严重贫血并增加发病率。通常建议通过质子泵抑制剂或组胺2受体阻滞剂静脉内施用酸抑制剂。假设/目的要评估静脉内给予埃索美拉唑,pan托拉唑和法莫替丁恒速输注(CRI)对提高犬胃内pH的功效。我们假设埃索美拉唑和法莫替丁CRI与to托拉唑相比可提供更好的酸抑制作用,并达到治疗胃肠道出血的pH值目标。动物九个健康研究小猎犬。方法随机三向交叉。犬在第12h静脉给予1 mg / kg的pan托拉唑或埃索美拉唑和法莫替丁,负荷剂量为1 mg / kg,然后连续8天每天静脉给予CRI 8 mg / kg。在基线和治疗72小时时记录胃内pH。比较治疗组之间和治疗组内的平均pH和平均胃内pH≥3或≥4。结果在所有3种处理中,随着时间的推移,平均pH均显着增加(P <0.0001),MPT≥3(P <0.001)和MPT≥4(P = 0.0006)。对于平均pH,MPT≥3和MPT≥4的处理,时间效果没有差异(分别为P = 0.29,.56和.37);但是,只有埃索美拉唑和法莫替丁CRI达到了确定的解决人胃十二指肠溃疡的目标。结论和临床意义法莫替丁CRI和埃索美拉唑在治疗的前72小时与标准剂量的top托拉唑相比可能是更好的酸抑制剂。比较治疗组之间和治疗组内的平均pH和平均胃内pH≥3或≥4。结果在所有3种处理中,随着时间的推移,平均pH均显着增加(P <0.0001),MPT≥3(P <0.001)和MPT≥4(P = 0.0006)。对于平均pH,MPT≥3和MPT≥4的处理,时间效应没有差异(分别为P = 0.29,.56和.37);但是,只有埃索美拉唑和法莫替丁CRI达到了确定的解决人胃十二指肠溃疡的目标。结论和临床意义法莫替丁CRI和埃索美拉唑在治疗的前72小时与标准剂量的top托拉唑相比可能是更好的酸抑制剂。比较治疗组之间和治疗组内的平均pH和平均胃内pH≥3或≥4。结果在所有3种处理中,随着时间的推移,平均pH均显着增加(P <0.0001),MPT≥3(P <0.001)和MPT≥4(P = 0.0006)。对于平均pH,MPT≥3和MPT≥4的处理,时间效果没有差异(分别为P = 0.29,.56和.37);但是,只有埃索美拉唑和法莫替丁CRI达到了确定的解决人胃十二指肠溃疡的目标。结论和临床意义法莫替丁CRI和埃索美拉唑在治疗的前72小时与标准剂量的top托拉唑相比可能是更好的酸抑制剂。结果在所有3种处理中,随着时间的推移,平均pH均显着增加(P <0.0001),MPT≥3(P <0.001)和MPT≥4(P = 0.0006)。对于平均pH,MPT≥3和MPT≥4的处理,时间效应没有差异(分别为P = 0.29,.56和.37);但是,只有埃索美拉唑和法莫替丁CRI达到了确定的解决人胃十二指肠溃疡的目标。结论和临床意义法莫替丁CRI和埃索美拉唑在治疗的前72小时与标准剂量的top托拉唑相比可能是更好的酸抑制剂。结果在所有3种处理中,随着时间的推移,平均pH均显着增加(P <0.0001),MPT≥3(P <0.001)和MPT≥4(P = 0.0006)。对于平均pH,MPT≥3和MPT≥4的处理,时间效果没有差异(分别为P = 0.29,.56和.37);但是,只有埃索美拉唑和法莫替丁CRI达到了确定的解决人胃十二指肠溃疡的目标。结论和临床意义法莫替丁CRI和埃索美拉唑在治疗的前72小时与标准剂量的top托拉唑相比可能是更好的酸抑制剂。只有埃索美拉唑和法莫替丁CRI达到了确定的治疗人胃十二指肠溃疡的目标。结论和临床意义法莫替丁CRI和埃索美拉唑在治疗的前72小时与标准剂量的top托拉唑相比可能是更好的酸抑制剂。只有埃索美拉唑和法莫替丁CRI达到了确定的治疗人胃十二指肠溃疡的目标。结论和临床意义法莫替丁CRI和埃索美拉唑在治疗的前72小时与标准剂量的top托拉唑相比可能是更好的酸抑制剂。
更新日期:2020-02-05
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