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Erythromycin Facilitates Postpyloric Placement of Nasoduodenal Feeding Tubes in Intensive Care Unit Patients: Randomized, Double‐Blinded, Placebo‐Controlled Trial
Author(s) -
Kalliafas Stavros,
Choban Patricia S.,
Ziegler Daniel,
Drago Stefano,
Baum Louis Flano
Publication year - 1996
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607196020006385
Subject(s) - medicine , duodenum , randomized controlled trial , placebo , intensive care unit , feeding tube , diabetes mellitus , intensive care , surgery , anesthesia , gastroenterology , intensive care medicine , alternative medicine , pathology , endocrinology
Background: To determine whether administration of erythrornycin (E) could facilitate passage of a nasoenteric feeding tube into the duodenum for postpyloric feedings, this randomized, double‐blind, placebo‐controlled trial was performed. Methods: Fifty‐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. Results: Overall, 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). Conclusions: These 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. (journal of Parenteral and Enteral Nutrition 20: 385–388, 1996)