Optimal dose and duration of enteral erythromycin as a prokinetic: A surgical intensive care experience
Autor: | M. M. Nainthramveetil, Muna Al Maslamani, Jazib Hassan, Shoaib Nawaz, Ahmed Atef Shible, Nissar Shaikh, Rajvir Singh, Edin Karic |
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Rok vydání: | 2021 |
Předmět: |
030213 general clinical medicine
gastroparesis Metoclopramide Dose 0206 medical engineering diarrhea Erythromycin 02 engineering and technology Enteral administration 03 medical and health sciences 0302 clinical medicine laparotomy medicine gastrointestinal hypo mobility Gastroparesis Brain injury Adverse effect business.industry General Medicine medicine.disease 020601 biomedical engineering multiorgan dysfunction Diarrhea Parenteral nutrition erythromycin Anesthesia medicine.symptom business metoclopramide Research Article medicine.drug |
Zdroj: | Qatar Medical Journal |
ISSN: | 2227-0426 0253-8253 |
Popis: | Background: Enteral feeding has various advantages over parenteral feeding in critically ill patients. Acutely ill patients are at risk of developing enteral feeding intolerance. Prokinetic medications improve gastrointestinal mobility and enteral feed migration and absorption. Among the available prokinetic agents, erythromycin is the most potent. Erythromycin is used in different dosages and durations with variable efficacy. Intravenous erythromycin has an early and high rate of tachyphylaxis; hence, enteral route is preferred. Recently, the combination of prokinetic medications has been increasingly used because they accelerate the prokinetic action and decrease the adverse effects. Aim: This study aimed to determine the optimal effective prokinetic dose and duration of administering enteral erythromycin in combination with metoclopramide in critically ill patients. Patients and methods: This study has a prospective observation design. After obtaining permission from the medical research center of the institution, all patients in the surgical and trauma intensive care unit having enteral feed intolerance and those who were already on metoclopramide for 24 hour (h) were enrolled in the study. Patients’ demographic data, diagnosis, surgical intervention, disease severity scores, erythromycin dose, duration of administration, any adverse effects, factors affecting erythromycin response, and outcome were recorded. All patients received 125 mg syrup erythromycin twice daily through a nasogastric tube (NGT). The NGT was clamped for 2 h, and half amount of previous enteral feeds was resumed. If the patient did not tolerate the feeds, the erythromycin dose was increased every 24 h in the increment of 250, 500, and 1000 mg (Figure 1). Statistical significance was considered at P |
Databáze: | OpenAIRE |
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