[Attempt at preventive treatment of esophagitis caused by intubation during intensive care]

A randomized prospective trial was designed to evaluate the preventive treatment of esophagitis in 31 intensive care patients who had a nasogastric feeding tube for at least 10 days. Fourteen patients (group B) received no preventive treatment while 17 patients (group A) received 300 mg of cimetidine every 6 h intravenously and 11 g of colloidal aluminium phosphate every 4 h per os. All patients were fed a standard diet through their nasogastric tube at a constant rate of 30 Kcal/kg/day. Endoscopic controls at day 1 and 10 showed that the number of initial and final esophagitis was not different in groups B and A: 7 and 8 at day 1, 11 and 10 at day 10, respectively. The inefficiency of this preventive treatment suggested that acid gastroesophageal reflux is not a major factor in the occurrence of nasogastric feeding tube-induced esophagitis. However as esophagitis is associated with a more severe Knaus index and a greater number of gastric stress ulcer risk factors, it is suggested that decreased defense of the mucosa may be a key factor in the occurrence of this type of esophagitis.