ICU PATIENT CARE: SERIES OF BASICS - 6

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Patients from the time of birth to 28 days of age are called as neonates. As I was discussing about GI prophylaxis in different age groups of ICU patients, in this article I'll be covering neonatal GI prophylaxis.

Inappropriate indications for the use of pharmacologic stress ulcer prophylaxis

○ Continuation of SUP when there is no high-risk situations.

○ When the risk of SUP outweighs it's benefit.

Potential risks of SUP in neonates:

■ Hypergastrinemia

■ Enterochromaffin-like cell       hyperplasia

■ Carcinoid formation

■ Vitamin B12 deficiency

■ Hypomagnesemia

■ Necrotizing enterocolitis

■ Osteoporosis

■ Atrophic gastritis

■ Infection

Neonatal Dosing:

Pantoprazole:

Parenteral Dose: 0.5-1 mg/kg IV OD.

(Do not exceed adult

doses listed above)

Enteral Dose: 0.5-1 mg/kg PO/NG

Famotidine:

Parenteral Dose: 0.5 mg/kg/dose IV QID

Enteral Dose: 0.5 mg/kg/dose PO/NG

The use of sucralfate in neonates is not recommended and may be harmful due to the risk of bezoar formation, particularly in neonates with gastrointestinal motility disorders, and aluminum toxicity in neonates with renal impairment.


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