From Life in the Fast Lane:
PROTON PUMP INHIBITOR: Pantoprazole 80 mg IV loading dose, followed by 8 mg/hour for 72 hours.
- ACG: Why we do it: “PPI therapy may be considered to decrease the proportion of patients who have higher risk stigmata of hemorrhage at endoscopy and who receive endoscopic therapy. If endoscopy will be delayed or cannot be performed, intravenous PPI is recommended to reduce further bleeding”
- Evidence: A Cochrane meta-analysis of six randomized trials (N = 2 ,223) of pre-endoscopic PPI therapy found no significant differences between PPI and control in mortality, rebleeding, or surgery.
- Evidence: A second Cochrane meta-analysis of randomized trials of patients showed that PPI therapy was associated with reduced rebleeding and surgery, but not mortality. In situations of delayed endoscopy or unavailable endoscpy, PPI therapy may improve clinical outcomes.