Effective administration method of intravenous proton pump inhibitor: A novel testing using a BRAVO catheterless pH monitoring system

Abstract

This study investigated the use of the BRAVO catheterless pH monitoring system to determine the effective administration method of intravenous proton pump inhibitor and the effectiveness of 80 mg pantoprazole per day on the regulation of gastric acid. A total of 32 patients who underwent endoscopic resection were randomly assigned to the repeated bolus injections group (40 mg dose, twice per day) and continuous infusion group (mixed with 5% glucose, continuous infusion of 80 mg per day). Then, pantoprazole was administered and intragastric pH was measured for 48 hours through a BRAVO capsule. The length of time until the intragastric pH reached 4 and 6 after administration was measured, as well as the mean/median pH for 48 hours and the fraction times (%) of pH >4 and >6 for 48 hours. The factors affecting intragastric pH were also analyzed. There were no complications due to the attachment of the BRAVO capsule. No significant differences according to administration methods were found in all factors. Only Helicobacter pylori had significant effect on the fraction times (%) of pH >4 and >6 for 48 hours (p<0.05). The effects of intravenous proton pump inhibitor were similar between the administration methods. Therefore, the repeated bolus injection method, which is relatively simple, is a good choice. Regarding the dose of intravenous pantoprazole, which is used after successful endoscopic hemostasis, 80 mg would be sufficient. We hope that this study encourages the use of the BRAVO catheterless pH monitoring system.