Biopsy-Proven Gastric Pathological Findings in Mechanically Ventilated Intensive Care Unit Patients

Objectives Helicobacter pylori (H. pylori ) is known to affect a large proportion of the world population. It plays a role in the pathogenesis of peptic ulcer (PU) and increases the likelihood of bleeding. In critically ill patients in intensive care units (ICUs), the risk of bleeding may be much higher due to many concomitant factors. The study aimed to determine the activation of H. pylori in mechanically ventilated (MV) intensive care patients and compare this with the general population. Methods This study was performed retrospectively by screening patients who underwent esophagogastroduodenoscopy and histopathological sampling in our hospital between January and June 2023. The study included 79 patients aged between 18 and 85 years. The patients were categorized into two groups: 35 patients in the ICU with mechanical ventilation (MV) support (E MV ) and 44 patients who presented to the gastroenterology department due to dyspeptic symptoms and underwent endoscopy ( ED ). Age; sex characteristics; laboratory parameters such as hemoglobin (Hb), hematocrit (Htc), mean cellular volume (MCV), white blood cell (WBC), neutrophil, platelet, glucose, urea, creatinine, aspartate transaminase (AST), alanine transaminase (ALT), C -reactive protein (CRP), albumin, ferritin, thyroidstimulating hormone (TSH), anti -hepatitis C virus (HCV), hepatitis B surface antigen (HBsAg), anti -HIV; and biopsy results ( H. pylori positivity, intestinal metaplasia, and atrophy) were recorded. Results A total of 79 patients who underwent gastric biopsy were assessed. There were 35 patients in the E MV group and 44 patients in the E D group. There was no difference in gender and age distribution between the groups. Hb and Htc were significantly lower in E MV compared to E D (p=0.001). Hb was 9.4 +/- 1.7 g/dL in E MV and 10.8 +/- 2.1 g/dL in E D . Htc was 29.6 +/- 5.1 in E MV and 33.5 +/- 5.7 in E D . MCV, WBC, glucose, urea, AST, ALT, CRP, and ferritin values were statistically significantly higher in E MV (p<0.05). Albumin and creatinine levels were statistically significantly lower in E MV (p<0.05). There was no significant difference between the groups in terms of neutrophils, platelets, and TSH. In the E MV group, H. pylori activity was negative in 31 (88.6%) patients and positive in four (11.4%) patients. In the E D group, H. pylori activity was negative in 30 (68.2%) patients and positive in 14 (31.8%) patients. There was a statistically significant difference between the groups in terms of H. pylori positivity (p=0.032). Conclusions The prevalence of H. pylori in MV patients in the ICU is low compared to the average population. The incidence of atrophic gastritis and intestinal metaplasia is the same. The present study supports that ICU cases do not have a higher risk of gastric premalignant lesions compared to the average population.