Document Detail


Erythromycin reduces delayed gastric emptying in critically ill trauma patients: a randomized, controlled trial.
MedLine Citation:
PMID:  12352474     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Early enteral feeding has been shown to be beneficial in improving outcome in critically injured trauma patients. Delayed gastric emptying occurs frequently in trauma patients, increasing the time to achieve nutritional goals, and limiting the benefit of early enteral feedings. Intravenous erythromycin is an effective agent for improving gastric motility in diabetics and postgastrectomy patients. The purpose of this study is to determine the effectiveness of erythromycin for improving gastric motility in critically injured trauma patients. METHODS: All critically injured patients who received gastric feedings within 72 hours of admission were candidates for the study. Those patients who failed to tolerate feedings at 48 hours (gastric residual > 150 mL) were eligible for enrollment. Patients were prospectively assigned to two treatment groups by randomization to receive either erythromycin (ERY) or placebo (PLA). Treatment was continued in patients who tolerated gastric feedings until the feedings were no longer required. Patients with continued intolerance for 48 hours after randomization were considered failures of therapy and given metoclopramide. RESULTS: Sixty-eight patients were enrolled and were well matched for age, sex, and Injury Severity Score. Mortality, intensive care unit length of stay, hospital length of stay, number of ventilator days, and rate of nosocomial infections were similar in each group. There was a significant difference between the ERY group and the PLA group in the amount of feedings tolerated at 48 hours (58% vs. 44%, p = 0.001). There was no difference in the amount of feedings tolerated (as a percentage of target goal volume) throughout the entire duration of the study (ERY [65% of target] vs. PLA [59%], p = 0.061). Overall success of therapy at 48 hours was 56% in the ERY group versus 39% in the PLA group, but this also did not reach statistical significance (p = 0.22). CONCLUSION: Intravenous erythromycin improves gastric motility and enhances early nutritional intake in critically injured patients.
Authors:
John D Berne; Scott H Norwood; Clyde E McAuley; Van L Vallina; David Villareal; Jaye Weston; Jerry McClarty
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of trauma     Volume:  53     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-27     Completed Date:  2002-10-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  422-5     Citation Subset:  AIM; IM    
Affiliation:
Division of Trauma Services, East Texas Medical Center, Tyler, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Bacterial Agents / administration & dosage*,  pharmacology
Critical Care / methods
Critical Illness / therapy
Enteral Nutrition* / methods
Erythromycin / administration & dosage*,  pharmacology
Female
Gastric Emptying / drug effects*
Humans
Infusions, Intravenous
Injury Severity Score
Length of Stay
Male
Prospective Studies
Treatment Outcome
Wounds, Penetrating / mortality,  pathology*,  surgery,  therapy*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 114-07-8/Erythromycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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