Exposure to H2 receptor antagonists may be associated with increased risk of NEC and infections in preterm infants
BACKGROUND Inhibitors of gastric acid ( IGA ) are used for upper gastrointestinal bleeding or gastroesophageal reflux in preterm infants .
The result ant increase in gastric pH may enhance the growth of pathogens and increase the risk of necrotizing enterocolitis ( NEC ) .
Our systematic review examined the association between  IGA and NEC in preterm infants .
A randomized, controlled study of prophylactic ranitidine in preventing stress-induced gastric mucosal lesions in neonatal intensive care unit patients.
OBJECTIVE To assess endoscopically the effect of prophylactic short-term ranitidine treatment in the prevention of  stress-induced gastric lesions  in neonatal intensive care unit ( ICU ) patients . DESIGN Prospect i ve , r and omized study . SETTING Department of Neonatal Intensive Care , University Hospital of Tampere . PATIENTS Fifty-three infants were enrolled in a r and omized , controlled study . Forty-eight ( 90 % ) of these patients underwent endoscopic examination and were evaluated . INTERVENTIONS A histamine-2-receptor blocker , ranitidine , was given prophylactically after birth for 4 days to infants mechanically ventilated and treated in the neonatal ICU . The gastric mucosa was both visually and histologically evaluated after 3 to 6 days , and the outcome of the infants was registered . MEASUREMENTS AND MAIN RESULTS In the 23 infants prophylactically treated with ranitidine , the gastric mucosa was visually classified as normal in 14 ( 61 % ) infants as compared with five ( 20 % ) of 25 controls ( p < .004 ) . Histologic lesions showed parallel results ( 57 % vs. 16 % , p < .004 ) . Eight gastric ulcers were diagnosed endoscopically in the control group vs. none in the treatment group . The ulcers were all clinical ly " silent " at the time of endoscopy . According to logistic regression modeling , the decreased risk for gastric mucosal lesions in infants receiving prophylactic ranitidine was 0.03 ( 95 % confidence interval 0.003 to 0.178 ) . Surfactant treatment for infant respiratory distress syndrome also decreased the risk for stress-induced gastric mucosal lesions ( odds ratio 0.083 ; 95 % confidence interval 0.009 to 0.788 ) , whereas other variables ( birth weight , gestational age , Apgar scores , cord blood pH , and duration of intubation ) had no significant effect . No side effects could be attributed to the ranitidine treatment . CONCLUSION We conclude that short-term prophylactic ranitidine treatment prevents gastric mucosal lesions in newborn infants under stress
Exposure to H2 receptor antagonists may be associated with increased risk of NEC and infections in preterm infants
BACKGROUND Inhibitors of gastric acid ( IGA ) are used for upper gastrointestinal bleeding or gastroesophageal reflux in preterm infants .
The result ant increase in gastric pH may enhance the growth of pathogens and increase the risk of necrotizing enterocolitis ( NEC ) .
Our systematic review examined the association between  IGA and NEC in preterm infants .