Prokinetic drugs for gastric emptying in critically ill ventilated patients: Analysis through breath testing

Journal of Critical Care
Moshe HerschSharon Einav

Abstract

The prupose was to identify, through the BreathID automatic breath-testing device, the best prokinetic therapy to enhance gastric-emptying rate (GER) in ventilated intensive care unit patients. This was a prospective, crossover, nonrandomized study. Consecutive ventilated patients who could be fed enterally and expected to require 5 days of ventilation were included. (13)C-labeled-acetate in 100 mL Osmolite (BreathID; Exalenz Bioscience Ltd, Jerusalem, Israel) was administered intragastrically and followed by a 4-hour continuous recording of expiratory (13)CO2 by the BreathID. Prokinetics were changed daily: (1) baseline (no prokinetic), (2) intravenous (IV) metoclopramide (10 mg every 6 hours), (3) IV metoclopramide (10 mg every 6 hours) and continuous low-dose erythromycin (10 mg/h), (4) IV continuous low-dose erythromycin alone (10 mg/h), and (5) IV bolus erythromycin (200 mg every 12 hours). Gastric-emptying rate was assessed by the percentage dose recovered (PDR)-change from time 0 of the recording in the ratio of (13)CO2/(12)CO2 in exhaled gases (%/h). We used PDR peak values and time to peak (minutes to reach PDR peak) to express GER. In the first 17 patients (group A), baseline GER measurements preceded prokinetic thera...Continue Reading

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Citations

Jan 25, 2017·Journal of Comparative Effectiveness Research·Masoume MalekolkottabAnahid Nourian
Oct 9, 2018·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Adam M DeaneAnton Emmanuel
Jun 28, 2019·Current Opinion in Critical Care·Adam M DeaneYasmine Ali Abdelhamid
Mar 12, 2019·Current Opinion in Critical Care·Mark P PlummerAdam M Deane
Dec 19, 2020·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Vikram Rangan, Andrew Ukleja
Nov 15, 2020·The Veterinary Clinics of North America. Small Animal Practice·Roman Husnik, Frédéric Gaschen

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