[Nosocomial lung infections. Epidemiology and problems of stress ulcer prevention]

Abstract

The incidence of pulmonary complications in patients with tracheal intubation is 17-25%. The mortality rate is considered to be between 50 and 81%. Aspiration of contaminated gastric fluid has been suggested to be a source of many of these complications. Gastric fluid contamination depends on the pH of the gastric fluid among other things. This results in a much higher incidence of nosocomial pneumonias in patients receiving H2-blockers (36%) or antacids and H2-blockers (38%) than placebo (8%) or sucralfate (10%). In contrast H2-blockers, antacids, omeprazole, pirenzepine and sucralfate show similar bleeding rates due to stress ulcers, but all are significantly lower than that of placebo. The routine application of prophylaxis for stress ulcer bleeding should nowadays be reserved for risk patients only. If necessary antimuscarinic drugs or sucralfate should be applied.