RANITIDINE TREATMENT OF STRESS-INDUCED GASTRIC LESIONS IN NEWBORNS

Abstract

Stress-induced gastric mucosal lesions are a common complication in preterms and term newborns treated in intensive care. These lesions appear before any symptoms have occurcd. For adult patients in the intensive care ranitidine has been used as a profylactic treatment. We have now performed a double-blind randomized contiolled study where 48 newborn infants were enrolled (mean gestational age 32 weeks, range 24-41 and mean birth weight 1830g, range 620-4550). All infants were mechanically ventilated from birth mostly because of prematurity. 23 of the infants received profylactic ranitidine 5 mg/kg body weght/day divided in three doses during four days starting at the day of birth. 25 of the infants received no medication, Gastroscopy was performed with Olympus GIF 5.2 baby gastroscope at the day 3 to 7 to all of the neonates in both groups. Those receiving ranitidine were free of ulcers, 2 had gastritis, 7 had mucosal haemorrhage and 14 had normal mucosa: In contrast, ulcers were seen in 8 of the neonates without profylaclic treatment, gastritis in 8, haemorrhage in 4 and only 5 had normal appearing mucosa (p=0.004). Between the groups there was no difference in occurence of nosocomial infections. No side-effects ol the short-term ranitidine treatment was observed. This study shows that a four-day profylactic ranitidine treatment reduces the occurence of gastric lesions in preterm and term infants under stress.

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