Feeding intolerance in critically ill patients Feeding intolerance, Critically ill
Conditions
Interventions
In the enteral erythromycin arm, each participant will receive Erythromycin syrup (125 mg/5mL) 5 mL via enteral route and placebo 0.9% NaCl solution 2 mL via intravenous route every 6 hours for a tota
Active Comparator Drug,Active Comparator Drug
Enteral erythromycin ,Intravenous metoclopramide
Sponsors
Faculty of Medicine Siriraj Hospital, Mahidol University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Age 18 years old or older. 2. Critically ill patient which consist of a. Patient admitted to Intensive care unit b. Patient admitted to general medicine ward receiving ventilatory support by ventilator or vasopressor/ inotropes 3. The gastric residual volume measured after feeding initiation for more than 6 hours is 200 mL or greater. 4. The attending physician dosen't have other explanation for increased gastric residual volume. 5. The attending physician considers the necessity of using prokinetic drugs. 6. The patient or authorized representative consents to participate in the trial and signs the consent form.
Exclusion criteria
Exclusion criteria: 1. Administration of any prokinetic drugs within the previous 24 hours 2. Known allergy to metoclopramide or macrolide antibiotics 3. Recent abdominal surgery within 6 weeks prior to the enrollment in the trial 4. Past history of esophagus and stomach surgery 5. Suspected bowel obstruction or perforation 6. Evidence of liver dysfunction a. Transaminase levels increased to more than twice the upper limit of normal. b. Prothrombin time increased to more than twice the upper limit of normal. c. more than three times elevation above the upper limit of normal of Total bilirubin 7. Administration of drug known to have interaction with the study drug, such as carbamazepine, warfarin, theophylline, and digoxin. 8. History of ventricular arrhythmia or QT interval prolongation more than 480 ms fon a 12-lead electrocardiogram. 9. Diagnosed with myasthenia gravis 10. Pregnant or breastfeeding
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Successful feeding within 48 hours Within 48 hours after administration of medication according to treament arm Measure gastric residual volume every 6 hours before each feeding session | — |
Secondary
| Measure | Time frame |
|---|---|
| Successful feeding within 5 days within 5 days after administration of medication according to treatment arm Measure gastric residual volume every 6 hours before each next feeding session,Time to successful feeding Within 5 days after administration of prokinetics Measure time after administration of prokinetics,Daily gastric residual volume Within 5 days after administration of prokinetics Measure gastric residual volume every 6 hours before each next feeding session,Average daily delivered to target energy ratio Within 5 days after administration of prokinetics Measure gastric residual volume every 6 hours before each next feeding session and calculate average daily delivered to target energy ratio,Average daily delivered to ordered energy ratio Within 5 days after administration of prokinetics Measure gastric residual volume every 6 hours before each next feeding session and calculate average daily delivered to ordered energy ratio,Hospital length of stay At the time of discharge from hospital Time form hospital admission to discharge,28-days mortality rate 28 days after administration of prokinetics Mortality,Adverse event rate Within 5 days after administration of prokinetics Any adverse events | — |
Countries
Thailand
Contacts
Public ContactChailat Maluangnon
Faculty of Medicine Siriraj Hospital
Outcome results
None listed