title: Erythromycin and position facilitated placement of postpyloric feeding tubes in burned patients.
abstract: BACKGROUND
  One of the main difficulties encountered in enteral nutrition in critically ill patients is the impaired gastric emptying: while the small bowel is ready the stomach is still 'lazy'. This paper describes a simple bedside method for postpyloric feeding tube placement, using a gastric prokinetic agent, erythromycin, and patient positioning.
  
  
  METHODS
  In eight critically ill, burned patients a gastric feeding tube was placed in a reverse Trendelenburg, right lateral decubitus position. A dose of 250 mg of erythromycin was administered intravenously.
  
  
  RESULTS
  In 13 out of 14 attempts, the tube passed into the duodenum, a success rate of 92%.
  
  
  CONCLUSIONS
  Combining the prokinetic effects of erythromycin with proper patient positioning allows a rapid bedside transpyloric placement of feeding tubes.
authors.affiliation: Department of Surgery, New York Methodist Hospital, Brooklyn, and Cornell University Medical College, New York, N.Y., USA.
authors.forename: I K
authors.initials: IK
authors.lastname: Komenaka
authors.forename: K
authors.initials: K
authors.lastname: Giffard
authors.forename: J
authors.initials: J
authors.lastname: Miller
authors.forename: M
authors.initials: M
authors.lastname: Schein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000628:therapy*; D016638:Critical Illness; D004750:Enteral Nutrition / Q000379:methods*; D004917:Erythromycin / Q000494:pharmacology / Q000627:therapeutic use*; D005746:Gastric Emptying / Q000187:drug effects; D005765:Gastrointestinal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture
chemical_list: D005765:Gastrointestinal Agents; D004917:Erythromycin