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Erythromycin vs metoclopramide for facilitating gastric emptying and tolerance to intragastric nutrition in critically ill patients.

Publication ,  Journal Article
MacLaren, R; Kiser, TH; Fish, DN; Wischmeyer, PE
Published in: JPEN J Parenter Enteral Nutr
2008

BACKGROUND: The purpose of this study is to evaluate erythromycin vs metoclopramide for facilitating gastric emptying and tolerance to intragastric enteral nutrition (EN). METHODS: Twenty critically ill patients with a gastric residual >150 mL while receiving EN were randomized to receive 4 intravenous doses of erythromycin 250 mg or metoclopramide 10 mg, each administered every 6 hours. Acetaminophen 975 mg was administered enterally at baseline and after the fourth dose. Acetaminophen peak plasma concentration (Cmax), concentration at 60 minutes (C(60)), time to Cmax (Tmax), and area under the concentration-time curve from 0 to 60 minutes (AUC(0-60)) were determined. Residual volumes and feeding rates were recorded. RESULTS: Compared with baseline, erythromycin increased Cmax (9.5 +/- 6.1 mg/L to 17.7 +/- 11.9 mg/L, P < .01), C(60) (5.4 +/- 3.5 mg/L to 12.9 +/- 7.6 mg/L, P < .01), and AUC(0-60) (3.5 +/- 3.0 mg.h/L to 12.5 +/- 8.7 mg.h/L, P < .01), while metoclopramide increased only AUC(0-60) (4.4 +/- 2.8 mg.h/L to 9.5 +/- 3.8 mg.hr/L, P < .05). Neither agent significantly reduced Tmax. Both erythromycin and metoclopramide reduced residual volumes (122 +/- 48 mL to 36 +/- 48 mL, P < .01, and 103 +/- 88 mL to 21 +/- 23 mL, P < .05, respectively) and allowed increased feeding rates (17 +/- 23 mL/h to 45 +/- 21 mL/h, P < .05, and 14 +/- 17 mL/h to 44 +/- 22 mL/h, P < .05, respectively). CONCLUSIONS: Both agents facilitate tolerance to intragastric EN, but erythromycin may be more effective than metoclopramide for enhancing gastric motility.

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Published In

JPEN J Parenter Enteral Nutr

DOI

ISSN

0148-6071

Publication Date

2008

Volume

32

Issue

4

Start / End Page

412 / 419

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Nutrition & Dietetics
  • Middle Aged
  • Metoclopramide
  • Male
  • Intubation, Gastrointestinal
  • Humans
  • Gastrointestinal Agents
  • Gastric Emptying
  • Female
 

Citation

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MacLaren, R., Kiser, T. H., Fish, D. N., & Wischmeyer, P. E. (2008). Erythromycin vs metoclopramide for facilitating gastric emptying and tolerance to intragastric nutrition in critically ill patients. JPEN J Parenter Enteral Nutr, 32(4), 412–419. https://doi.org/10.1177/0148607108319803
MacLaren, Robert, Tyree H. Kiser, Douglas N. Fish, and Paul E. Wischmeyer. “Erythromycin vs metoclopramide for facilitating gastric emptying and tolerance to intragastric nutrition in critically ill patients.JPEN J Parenter Enteral Nutr 32, no. 4 (2008): 412–19. https://doi.org/10.1177/0148607108319803.
MacLaren R, Kiser TH, Fish DN, Wischmeyer PE. Erythromycin vs metoclopramide for facilitating gastric emptying and tolerance to intragastric nutrition in critically ill patients. JPEN J Parenter Enteral Nutr. 2008;32(4):412–9.
MacLaren, Robert, et al. “Erythromycin vs metoclopramide for facilitating gastric emptying and tolerance to intragastric nutrition in critically ill patients.JPEN J Parenter Enteral Nutr, vol. 32, no. 4, 2008, pp. 412–19. Pubmed, doi:10.1177/0148607108319803.
MacLaren R, Kiser TH, Fish DN, Wischmeyer PE. Erythromycin vs metoclopramide for facilitating gastric emptying and tolerance to intragastric nutrition in critically ill patients. JPEN J Parenter Enteral Nutr. 2008;32(4):412–419.
Journal cover image

Published In

JPEN J Parenter Enteral Nutr

DOI

ISSN

0148-6071

Publication Date

2008

Volume

32

Issue

4

Start / End Page

412 / 419

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Nutrition & Dietetics
  • Middle Aged
  • Metoclopramide
  • Male
  • Intubation, Gastrointestinal
  • Humans
  • Gastrointestinal Agents
  • Gastric Emptying
  • Female