title: Rhubarb to Facilitate Placement of Nasojejunal Feeding Tubes in Patients in the Intensive Care Unit.
abstract: BACKGROUND
  Prokinetic agents are sometimes needed to aid in the placement of nasojejunal feeding tubes in patients at risk of malnutrition. The objective of the present study was to evaluate the feasibility of rhubarb as a new prokinetic agent to replace metoclopramide and erythromycin in the placement of nasojejunal feeding tubes.
  
  
  METHODS
  Ninety-four patients who required jejunal feeding tube insertion were included. They were divided into rhubarb (n = 34), metoclopramide (n = 31), and erythromycin groups (n = 29), depending on the use of rhubarb, metoclopramide, and erythromycin as the prokinetic agent. The jejunal feeding tube insertions were performed at the bedside. An abdominal x-ray was taken as the gold standard to determine the position of the tube. Cases in which insertion failed in either group were subjected to a second insertion attempt using rhubarb as the prokinetic agent.
  
  
  RESULTS
  The success rates in the rhubarb, metoclopramide, and erythromycin groups were 91.2%, 87.1%, and 89.7%, respectively. The difference in the success rates was not statistically significant (P = .916). The insertion times in the rhubarb, metoclopramide, and erythromycin groups were 16.0 ± 1.9 minutes, 18.0 ± 1.9 minutes, and 18.8 ± 2.2 minutes, respectively. The insertion time in the rhubarb group was significantly shorter than those in metoclopramide and erythromycin groups (P < .001). No side effects were noted in the rhubarb group.
  
  
  CONCLUSIONS
  Rhubarb could serve as an effective prokinetic agent to promote the insertion of nasojejunal feeding tubes.
authors.affiliation: Department of Intensive Care Unit, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Intensive Care Unit, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
authors.forename: Yufang
authors.initials: Y
authors.lastname: Gu
authors.affiliation: Department of Intensive Care Unit, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China efyiculijing@163.com.
authors.forename: Rong
authors.initials: R
authors.lastname: Zhou
mesh_terms: D000368:Aged; D004750:Enteral Nutrition / Q000379:methods*; D004917:Erythromycin / Q000008:administration & dosage*; D005240:Feasibility Studies; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage*; D006801:Humans; D007362:Intensive Care Units; D007441:Intubation, Gastrointestinal / Q000379:methods*; D007583:Jejunum; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage*; D008875:Middle Aged; D009296:Nasal Cavity; D011446:Prospective Studies; D012250:Rheum
chemical_list: D005765:Gastrointestinal Agents; D004917:Erythromycin; D008787:Metoclopramide
keywords: critical care; enteral nutrition; enteral tube placement; erythromycin; metoclopramide; nutritional support; rhubarb