Daily IV Pantoprazole Saves Costs, Is Effective in Preventing ICU GI Bleeds

Objective: To explore the cost-effectiveness of intravenous pantoprazole versus no pantoprazole for the prophylaxis for upper gastrointestinal (GI) bleeding in mechanically ventilated patients. Design: Prospective economic evaluation as part of the REVISE (Reevaluating the Inhibition of Stress Erosions) trial from a public health respective; REVISE was randomized, blinded, and placebo controlled. Participants: 4821 patients (mean age, 58.2 years) from 68 ICUs in 8 countries, enrolled in the REVISE study, who were critically ill in the ICU. Methods: Patients received either 40 mg pantoprazole administered intravenously or normal saline placebo daily. The primary outcome was the cost to prevent any clinically important upper GI bleeding episode. The costs were all converted to U.S. dollars for the purpose of standardization. Primary outcome of the REVISE trial was the presence of clinically significant upper GI bleeding within 90 days with secondary outcomes of ventilator-associated pn more...