Metoclopramide improves gastric motility in critically ill patients.
OBJECTIVE
To assess the effect of metoclopramide on gastric motility in critically ill patients.


METHODS
Prospective, controlled, single-blind cross-over trial.


METHODS
A 10-bed general intensive care unit.


METHODS
Ten critically ill, enterally fed adult patients without renal failure.


METHODS
Each patient received enteral feeding with Enrich via a nasogastric tube at 50 ml/h throughout the 5-h study period on two consecutive days. Either normal saline (control) or 10 mg of metoclopramide (treatment) was administered intravenously at the start of the study period in random order with cross-over design.


RESULTS
Gastric motility was measured indirectly by analysis of the absorption over time of 1.5 g of paracetamol administered into the stomach at the start of the study period together with a 100 ml bolus of Enrich feed. The rate of gastric emptying is proportional to the area under the line plot of serum paracetamol concentration against time over 120 min (AUC120). Eight of the ten patients studied showed an increased AUC120 with metoclopramide compared to that with saline. Statistical analysis with the Wilcoxon signed rank test gave a p value of 0.04, indicating a significant increase in gastric emptying following administration of metoclopramide.


CONCLUSIONS
The administration of intravenous metoclopramide improved gastric emptying in a heterogeneous group of critically ill patients. Metoclopramide is a useful prokinetic drug in this patient population.
Department of Anaesthesia and Intensive Care, The Royal Free Hospital, London, UK. charl@cjooste.freeserve.co.uk
C A
CA
Jooste
J
J
Mustoe
G
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Collee
D000328:Adult; D016638:Critical Illness; D018492:Dopamine Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D004750:Enteral Nutrition; D005746:Gastric Emptying / Q000187:drug effects*; D006801:Humans; D007362:Intensive Care Units; D008787:Metoclopramide / Q000494:pharmacology / Q000627:therapeutic use*; D011446:Prospective Studies; D016037:Single-Blind Method; D018709:Statistics, Nonparametric
D018492:Dopamine Antagonists; D008787:Metoclopramide