The Effect of Two Different Doses of Omeprazole on Gastric pH in I.C.U. Patients

About 1.5-6 % of the patients with gastric and duodenal erosions admitted to I.C.U. are prone to gastrointestinal (G.I.) bleeding with its ensuing complications. Routine prophylaxis with H2-blockers and anti-acid has been used in these high risk patients for decades.In this study we evaluated the effect of P.O omeprazole, a potent acid inhibitor with prolong effects on gastric pH.  Patients with gastric pH higher than 4 and active G.I bleeding were excluded from the study.  The patients were given omeprazole in daily doses of 20 mg and 40 mg via nasogastric tube.Gastric pH was measured at8.00 A.M.about 30 min before each dose of omeprazole and thereafter every 8 hours for 3 days.  In 10 patients receiving 20 mg omeprazole mean intragastric pH increased from 2.6±0.13 to 4.28±0.33 (p<0.008) after treatment.  In 5 patients given 40 mg Omeprazole the corresponding pH value raised from 2.79±0.2 to 5.56±0.39. (p<0.001).  At the end of treatment, an intragastric pH of 4 prevailed in 50 and 100 percent of patients on 20 and 40 mg Omeprazole respectively.  In conclusion, the present study shows that omeprazole P.O in daily dose of 40 mg maintains gastric pH>4 in I.C.U. patients.