The Clinical Impacts Of Using Crushed Erythromycin Tablet Versus Intravenous Metclopramide As A Prokinetic Agents In Ventilated Critically Illness Patients Who Are Intolerant To Enteral Nutrition Formulas.
Journal Title: International Journal of Medical Science And Advanced Clinical Research (IJMACR) - Year 2019, Vol 2, Issue 3
Abstract
Background: Prokinetics like metoclopramide and erythromycin are commonly used in critically ill patients, mainly to aid in early enteral feeding, which is now recognized as one of the fundamentals of critical care practice. Objectives: The objective of this study is to test the positive impacts differences between using erythromycin as crushed tablet through nasogastric (NG) tube (Group I) in comparison with using metoclopramide 10 mg intravenously (Group II) thrice daily over 1 week regarding lowering gastric residual volume (GRV) in mechanically ventilated critically ill patients who are intolerant to standard enteral nutritional formulas. Materials and Methods: We will perform a retrospective analysis of patients admitted to the adult intensive care unit (ICU) between April 2017 and Sep 2018 who were their first week data can be obtained and weren’t discharged, extubated, or died before completed 1 week. Independent T-test will be conducted to determine the mean±SD and mean differences±SEM between Group I and II. Results: The mean overall age was 57.50±9.02 years, and 89 subjects (71.2%) were male. Group I had a significantly higher ∆GRV1-7 than Group II (-90.95±13.05 ml vs -66.59±6.26 ml, respectively) with mean difference of -24.36±1.80 ml. The overall 28-day ICU mortality rate was significantly lower in Group I than in Group II (45.76% vs 54.55%, respectively) with RRR of -16.11% and NNT of 12. Conclusion: Crushed erythromycin tablet is more effective than metoclopramide IV in reducing GRV and increasing feeding tolerance that may improve nutritional status, reduce bacterial translocation, hospital and ICU stay, and overall mortality.
Authors and Affiliations
Moh'd Nour
Keywords
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