Patients receiving PPIs or H2 antagonists prior to PICU admission should continue to receive these drugs.
Ranitidine 1mg/kg tds i.v. max 50mg/dose should be used for stress ulcer prophylaxis.
- All patients should have prophylaxis by default, but this may be withheld if the following are all met:
- Full feeding is instituted
- Mechanical ventilation is likely to be less than 48 hours
- None of the following risk factors exist
- Haemodynamic instability
- Ventilation for >48 hours
- Fulminant liver failure
pH monitoring should ensure pH >4.
PPI may be used if pH <4, or following a gastric bleed.
Omeprazole i I.V.: 0.5mg/kg od (can increase to max of 2mg/kg)