• Jpen Parenter Enter · Nov 1996

    Randomized Controlled Trial Clinical Trial

    Erythromycin facilitates postpyloric placement of nasoduodenal feeding tubes in intensive care unit patients: randomized, double-blinded, placebo-controlled trial.

    • S Kalliafas, P S Choban, D Ziegler, S Drago, and L Flancbaum.
    • Department of Surgery, Ohio State University, Columbus 43210, USA.
    • Jpen Parenter Enter. 1996 Nov 1; 20 (6): 385-8.

    BackgroundTo determine whether administration of erythromycin (E) could facilitate passage of a nasoenteric feeding tube into the duodenum for postpyloric feedings, this randomized, double-blind, placebo-controlled trial was performed.MethodsFifty-seven patients were accrued from the surgical intensive care units (ICUs) of a tertiary-care university hospital. Patients enrolled were categorized as to the presence or absence of diabetes mellitus (DM). Those patients without DM were then subdivided into those with normal or depressed mental status. The three groups, normal (NMS), depressed mental status (DMS), or diabetes mellitus (DM), were then randomized independently to receive either E or placebo (P), followed by blind placement of a feeding tube. Tube placement was verified by an abdominal radiograph.ResultsOverall, the rate of postpyloric placement was 61% (19/31) in the E group, significantly better than 35% (9/26) in the P group (p < .05). In patients with NMS, the success rate with E was improved (64%, 9/14) compared with that with P (9%, 1/11) (p < .0005). In the DMS group, there was a 50% success rate (6/12) with E versus 63% (5/8) with P (not significant [NS]). In the DM group, 80% (4/5) of the patients had placement of the tube in the duodenum with E and 43% (3/7) with P (NS).ConclusionsThese data suggest that, overall, E is effective in facilitating placement of a nasoenteric feeding tube into the duodenum in ICU patients. It is clearly beneficial in those patients with normal mental status and may be useful in patients with diabetes mellitus.

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