• Jpen Parenter Enter · May 2010

    Comparative Study

    Treating delayed gastric emptying in critical illness: metoclopramide, erythromycin, and bedside (cortrak) nasointestinal tube placement.

    • Stephen J Taylor, Alexander R Manara, and Jules Brown.
    • Department of Nutrition and Dietetics, Frenchay Hospital, Bristol, UK. dusk@gotadsl.co.uk
    • Jpen Parenter Enter. 2010 May 1; 34 (3): 289-94.

    BackgroundWe describe experience using the Cortrak nasointestinal feeding tube and prokinetics in critically ill patients with delayed gastric emptying.MethodsPatient cohorts fed via a Cortrak electromagnetically guided nasointestinal tube (EGNT) or 14 French-gauge nasogastric tube plus prokinetics were retrospectively compared.ResultsOf 69 EGNT placements in 62 patients, 87% reached the small intestine. The median percentage of the enteral nutrition goal increased from 19% pre-EGNT to 80%-100% between days 1 and 10 post-insertion and was greater than in 58 patients prescribed metoclopramide (40%-87%: days 1-2, 5-7, P < or = .018) or 38 patients prescribed erythromycin (48%-98%; days 1 and 5, P < .0084). Up to day 10, the cumulative feeding days lost were lower for EGNT (1.06) than for metoclopramide (2.6, P < .02) or erythromycin (3.1, P < .02). The EGNT group had a lower use of prokinetics and lower treatment cost.ConclusionMost bedside EGNT placements succeed and, compared to nasogastric feeding plus prokinetics, increase enteral nutrition delivery and reduce both cumulative feeding days lost and prokinetic use.

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