Journal of Advanced Intensive and Critical Care Medicine

Abstract

Background: Early and adequate enteral nutrition in critically ill patients is associated with decreased rate of infection and improved outcomes. However, enteral feed intolerance (EFI) is common problem in critically ill patients admitted in ICU leading to increased morbidity and mortality. Prokinetics, mainly erythromycin and metoclopramide have been used to address EFI in critically ill patients. This study was carried out to compare the efficacy of erythromycin plus metoclopramide and erythromycin alone for EFI in critically ill patients.

Method: Total 60 patients were enrolled for the study with 30 patients in group A (erythromycin plus metoclopramide) and group B (erythromycin). EFI was diagnosed when gastric residual volume (GRV) was >500ml. Rate of successful feeding at 48 hours, daily accumulative GRV, total daily calorie intake, hospital mortality and 28day mortality were recorded.

Results: The number of patients achieving successful feeding were significantly higher in group A (40%) than in group B (23.3%) at 72 – 96 hours. The ratio of average calorie intake to target calorie intake was also higher in group A (85.32 ± 20.61) than in group B (69.41 ± 35.86), (p = 0.039). Average GRV for the first six days was lower in group A then group B (p<0.05).

Conclusion: In critically ill patients, erythromycin plus metoclopramide is more effective than erythromycin alone in treating enteral feed intolerance.