Erythromycin and position facilitated placement of postpyloric feeding tubes in burned patients.
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.
Komenaka
I K
IK
Department of Surgery, New York Methodist Hospital, Brooklyn, and Cornell University Medical College, New York, N.Y., USA.
Giffard
K
K
Miller
J
J
Schein
M
M
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
D005765:Gastrointestinal Agents; D004917:Erythromycin