Is there any benefit with pantoprazole treatment in infantile hypertrophic pyloric stenosis?
Context: Previous studies demonstrated faster correction of metabolic derangement associated with hypertrophic pyloric stenosis with pre-operative intravenous (IV) histamine-2 receptor antagonists. Aims: We investigated if similar outcomes are achieved with IV pantoprazole, a proton-pump inhibitor (...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | African Journal of Paediatric Surgery |
| Subjects: | |
| Online Access: | http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2022;volume=19;issue=1;spage=52;epage=55;aulast=Fourie |
| _version_ | 1798034218102554624 |
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| author | Natasha Fourie Marion Arnold Behrouz Banieghbal Samantha Lynn Marchant |
| author_facet | Natasha Fourie Marion Arnold Behrouz Banieghbal Samantha Lynn Marchant |
| author_sort | Natasha Fourie |
| collection | DOAJ |
| description | Context: Previous studies demonstrated faster correction of metabolic derangement associated with hypertrophic pyloric stenosis with pre-operative intravenous (IV) histamine-2 receptor antagonists. Aims: We investigated if similar outcomes are achieved with IV pantoprazole, a proton-pump inhibitor (PPI), including the subgroup of delayed presenters in the South African setting. Settings and Design: A 5-year retrospective record review (January 2014–December 2018) compared the rate of metabolic correction in patients with hypertrophic pyloric stenosis at two tertiary centres. Subjects and Methods: One centre routinely administers IV pantoprazole (1 mg/kg daily) preoperatively (PPI group) and the other does not (non-PPI group). Fluid administration, chloride supplementation and post-operative emesis were evaluated. Statistical Analysis: Spearman's rank correlation coefficient was used to calculate statistical significance for discrete dependent variables. Continuous variables were compared between the groups using the Student t-test. Fisher's exact contingency tables were used to classify categorical data and to assess the significance of outcome between two treatment options. P < 0.05 was considered statistically significant. Results: Forty-two patients received IV pantoprazole and 24 did not. The mean time of metabolic correction was 8 h shorter in the PPI group (P = 0.067). Total pre-operative chloride administration correlated to the rate of metabolic correction in both cohorts (P < 0.0001). Profound hypochloraemia (chloride <85 mmol/l) was corrected 23 h faster in the PPI group (P < 0.004). Post-operative emesis was noted: 0.45 episodes/patient in the PPI group and 0.75 episodes/patient in the non-PPI group (P = 0.01). Conclusions: Pre-operative IV pantoprazole administration showed a faster correction of metabolic derangements, and in profound hypochloraemia, the correction occurred substantially faster in the PPI group. Post-operative emesis was significantly less frequent in the PPI group. |
| first_indexed | 2024-04-11T20:41:11Z |
| format | Article |
| id | doaj.art-f430870632704cf79dab878ce8cf009e |
| institution | Directory Open Access Journal |
| issn | 0189-6725 |
| language | English |
| last_indexed | 2024-04-11T20:41:11Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | African Journal of Paediatric Surgery |
| spelling | doaj.art-f430870632704cf79dab878ce8cf009e2022-12-22T04:04:13ZengWolters Kluwer Medknow PublicationsAfrican Journal of Paediatric Surgery0189-67252022-01-01191525510.4103/ajps.AJPS_9_21Is there any benefit with pantoprazole treatment in infantile hypertrophic pyloric stenosis?Natasha FourieMarion ArnoldBehrouz BanieghbalSamantha Lynn MarchantContext: Previous studies demonstrated faster correction of metabolic derangement associated with hypertrophic pyloric stenosis with pre-operative intravenous (IV) histamine-2 receptor antagonists. Aims: We investigated if similar outcomes are achieved with IV pantoprazole, a proton-pump inhibitor (PPI), including the subgroup of delayed presenters in the South African setting. Settings and Design: A 5-year retrospective record review (January 2014–December 2018) compared the rate of metabolic correction in patients with hypertrophic pyloric stenosis at two tertiary centres. Subjects and Methods: One centre routinely administers IV pantoprazole (1 mg/kg daily) preoperatively (PPI group) and the other does not (non-PPI group). Fluid administration, chloride supplementation and post-operative emesis were evaluated. Statistical Analysis: Spearman's rank correlation coefficient was used to calculate statistical significance for discrete dependent variables. Continuous variables were compared between the groups using the Student t-test. Fisher's exact contingency tables were used to classify categorical data and to assess the significance of outcome between two treatment options. P < 0.05 was considered statistically significant. Results: Forty-two patients received IV pantoprazole and 24 did not. The mean time of metabolic correction was 8 h shorter in the PPI group (P = 0.067). Total pre-operative chloride administration correlated to the rate of metabolic correction in both cohorts (P < 0.0001). Profound hypochloraemia (chloride <85 mmol/l) was corrected 23 h faster in the PPI group (P < 0.004). Post-operative emesis was noted: 0.45 episodes/patient in the PPI group and 0.75 episodes/patient in the non-PPI group (P = 0.01). Conclusions: Pre-operative IV pantoprazole administration showed a faster correction of metabolic derangements, and in profound hypochloraemia, the correction occurred substantially faster in the PPI group. Post-operative emesis was significantly less frequent in the PPI group.http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2022;volume=19;issue=1;spage=52;epage=55;aulast=Fouriehypertrophic pyloric stenosispantoprazolepost-operative emesisserum chlorideshorter resuscitation time |
| spellingShingle | Natasha Fourie Marion Arnold Behrouz Banieghbal Samantha Lynn Marchant Is there any benefit with pantoprazole treatment in infantile hypertrophic pyloric stenosis? African Journal of Paediatric Surgery hypertrophic pyloric stenosis pantoprazole post-operative emesis serum chloride shorter resuscitation time |
| title | Is there any benefit with pantoprazole treatment in infantile hypertrophic pyloric stenosis? |
| title_full | Is there any benefit with pantoprazole treatment in infantile hypertrophic pyloric stenosis? |
| title_fullStr | Is there any benefit with pantoprazole treatment in infantile hypertrophic pyloric stenosis? |
| title_full_unstemmed | Is there any benefit with pantoprazole treatment in infantile hypertrophic pyloric stenosis? |
| title_short | Is there any benefit with pantoprazole treatment in infantile hypertrophic pyloric stenosis? |
| title_sort | is there any benefit with pantoprazole treatment in infantile hypertrophic pyloric stenosis |
| topic | hypertrophic pyloric stenosis pantoprazole post-operative emesis serum chloride shorter resuscitation time |
| url | http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2022;volume=19;issue=1;spage=52;epage=55;aulast=Fourie |
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