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Master Thesis

Étude de l'association entre l'utilisation des inhibiteurs de la pompe à protons et la survenue de complications infectieuses et métaboliques en service de réanimation et surveillance continue pédiatrique

Abstract : Objective: To evaluate the association of Proton Pump Inhibitors (PPIs) with the occurrence of nosocomial infections (NI) and hyponatremia in the pediatric intensive care unit (PICU). Method: A retrospective monocentric cohort study in the pediatric intensive care of the Universitary Hospital of Caen. All pediatric patients (<18 years old) admitted in the PICU from January 1st, 2017 to December 31st, 2018 were included and divided into 2 groups: PPI intake and non-PPI. Results: 768 patients were included: 234 patients received PPIs (30.6%) versus 534 (60.6%). After adjusting for confounding risk factors of NI multivariate analysis found and aOR (adjusted Odds-Ratio) of 2.42, 95% CI 1.17 - 5.14, p <0.05. The relative risk of hyponatremia with PPI was 5.18 95% CI 2.16-12.43, p <0.05. 178 patients received PPIs for stress ulcer prophylaxis (76.1%) when 22 patients (12.4%) had objective risk factors for stress ulcers. Conclusion: This study shows a significant and independent increase in the risk of NIs with the use of PPIs in the PICU. PPI prescriptions should be rationalized in the PICU especially for stress ulcer prophylaxis where the risk – benefit ratio is doubtful.
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Master Thesis
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Submitted on : Monday, March 2, 2020 - 12:44:55 PM
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Édouard Lacotte. Étude de l'association entre l'utilisation des inhibiteurs de la pompe à protons et la survenue de complications infectieuses et métaboliques en service de réanimation et surveillance continue pédiatrique. Médecine humaine et pathologie. 2019. ⟨dumas-02495605⟩

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