A retrospective observational cohort study depicted that using proton pump inhibitors (PPIs) exclusively in the intensive care unit (ICU), as opposed to throughout the entire hospital stay, may yield greater advantages for critically ill pediatric patients. Moreover, younger pediatric patients may experience relatively more benefits from Omeprazole compared to their older counterparts.

Fang-Fang Jiang et al. conducted this study to explore the relationship between the administration of PPIs during hospitalization and length of stay along with mortality. The study comprised 2269 pediatric ICU subjects aged 0 to 18 years, including 1378 users of Omeprazole and 891 non-Omeprazole users. To evaluate the impact of PPIs on mortality and other outcomes during hospitalization, the linear regression model, Cox proportional hazards model, Kaplan–Meier curves, and propensity score matching were employed.

The findings indicated a notable link between Omeprazole exposure and reduced critical care unit stay (β -0.042) but extended non-ICU hospital stay (β 0.121). Although no statistical significance was found for reduced mortality with Omeprazole exposure, the Omeprazole group showed a slight reduction in the tendency for in-hospital mortality (hazard ratio [HR] 0.726) and 28-day mortality (HR 0.701).

Subgroup analyses highlighted a more apparent decline in mortality tendency among pediatrics aged below 1 year, although not statistically significant. Additionally, Omeprazole exposure was profoundly correlated with declined mortality in the general ICU subgroup. Hence, administration of PPIs exclusively in the pediatric ICU, particularly for younger patients, is linked to reduced ICU stay but prolonged non-ICU hospital stay, with a slight decrease in mortality.