Comparing the Effects of Pantoprazole and Ranitidine on Serum Magnesium Level in Children Admitted to Pediatric Intensive Care Unit

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: This study aimed to compare the effects of pantoprazole and ranitidine on serum magnesium level in pediatric patients admitted in pediatric intensive care unit (PICU).Methods: In this clinical trial study, 70 patients admitted in pediatric intensive care unit divided into two groups of 35 patients. To prevent gastrointestinal complications, intravenous pantoprazole and ranitidine was prescribed in first and second group, respectively. The serum magnesium level was checked daily for seven days and compared. Data were analyzed using SPSS software.Findings: During the study, 18 patients (51.4%) in pantoprazole group and 21 patients (60%) in ranitidine group showed hypomagnesemia; but the difference between the two groups was not significant (P = 0.47). According to t-test, comparing the daily mean serum magnesium levels did not show significant difference between the groups.Conclusion: The prevalence of hypomagnesemia in both groups was high, but there was no difference between intravenous use of ranitidine or pantoprazole to prevent hypomagnesemia in critically ill pediatric patients.

Keywords

References

  1. Kraft MD, Btaiche IF, Sacks GS, Kudsk KA. Treatment of electrolyte disorders in adult patients in the intensive care unit. Am J Health Syst Pharm 2005; 62(16): 1663-82.
  2. Satish R, Gokulnath G. Serum magnesium in recovering acute renal failure. Indian J Nephrol 2008; 18(3): 101-4.
  3. Subhraprakashpramanik, Arpan Kumar, Pijushkantimandal, Shovan Kumar Das, Debasishghosh, Arpan Bhattacharya, Milan Chakraborty, Somnathdasgupta. Prevalence of hypomagnesemia and its predictive prognostic value in critically Ill medical patients. IOSR Journal of Pharmacy 2014; 4(1): 1-5.
  4. Kliegman RM, Stanton BMD, Geme JS, Schor NF. Nelson textbook of pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2015. p. 363.
  5. Kasper DL, Fauci AS, Hauser S, Longo D, Jameson JL. Harrison's principles of internal medicine. 19th ed. New York, NY: McGraw-Hill; 2015. p. 1929.
  6. Reveiz L, Guerrero-Lozano R, Camacho A, Yara L, Mosquera PA. Stress ulcer, gastritis, and gastrointestinal bleeding prophylaxis in critically ill pediatric patients: a systematic review. Pediatr Crit Care Med 2010; 11(1): 124-32.
  7. Rady HI, Emil A, Samy K, Baher S. Prediction of stress related gastrointestinal bleeding in critically III children using prism III Score. J Anesth Crit Care Open Access 2014; 1(4): 23.
  8. Stollman N, Metz DC. Pathophysiology and prophylaxis of stress ulcer in intensive care unit patients. J Crit Care 2005; 20(1): 35-45.
  9. Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Cohen NH, Young WL. Miller's anesthesia. 8th ed. Philadelphia, PA: Saunders; 2014. p. 508.
  10. Brunicardi F, Andersen D, Billiar T, Dunn D, Hunter J, Matthews J, et al. Schwartz's principles of surgery. 9th ed. New York, NY: McGraw-Hill; 2009. p. 333.
  11. Spirt MJ, Stanley S. Update on stress ulcer prophylaxis in critically ill patients. Crit Care Nurse 2006; 26(1): 18.
  12. Pemberton LB, Schaefer N, Goehring L, Gaddis M, Arrighi DA. Oral ranitidine as prophylaxis for gastric stress ulcers in intensive care unit patients: serum concentrations and cost comparisons. Crit Care Med 1993; 21(3): 339-42.
  13. Park CH, Kim EH, Roh YH, Kim HY, Lee SK. The association between the use of proton pump inhibitors and the risk of hypomagnesemia: a systematic review and meta-analysis. PLoS One 2014; 9(11): e112558.
  14. Epstein M, McGrath S, Law F. Proton-pump inhibitors and hypomagnesemic hypoparathyroidism. N Engl J Med 2006; 355(17): 1834-6.
  15. Singhi SC, Singh J, Prasad R. Hypo- and hypermagnesemia in an Indian Pediatric Intensive Care Unit. J Trop Pediatr 2003; 49(2): 99-103.
  16. Haque A, Saleem AF. On admission hypomagnesemia in critically ill children: Risk factors and outcome. Indian J Pediatr 2009; 76(12): 1227-30.
  17. Koulouridis I, Alfayez M, Tighiouart H, Madias NE, Kent DM, Paulus JK, et al. Out-of-hospital use of proton pump inhibitors and hypomagnesemia at hospital admission: a nested case-control study. Am J Kidney Dis 2013; 62(4): 730-7.
  18. The U.S. Food and Drug Administration (FDA). FDA Drug Safety Communication: Low magnesium levels can be associated with long-term use of proton pump inhibitor drugs (PPIs) [Online]. [cited 2011 Feb 3]; Available from: URL:
  19. https://www.fda.gov/Drugs/DrugSafety/ucm245011.htm
  20. Danziger J, William JH, Scott DJ, Lee J, Lehman LW, Mark RG, et al. Proton-pump inhibitor use is associated with low serum magnesium concentrations. Kidney Int 2013; 83(4): 692-9.
  21. Alhosaini MN, Leehey DJ, Vellanki K. Use of Proton Pump Inhibitors is Associated with Severe Hypomagnesemia in Kidney Transplant Recipients. Int J Nephrol Kidney Failure 2015; 2(1).
Journal of Isfahan Medical School
Volume 35, Issue 420 - Serial Number 420
January and February 2017
Pages 157-162

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History

  • Receive Date: 25 November 2016
  • Revise Date: 06 May 2024
  • Accept Date: 06 April 2022

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