Metoclopramide or domperidone improves post-pyloric placement of spiral nasojejunal tubes in critically ill patients: a prospective, multicenter, open-label, randomized, controlled clinical trial
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- 作者：Bei Hu (1)
Heng Ye (1)
Cheng Sun (1)
Yichen Zhang (1)
Zhigang Lao (2)
Fanghong Wu (3)
Zhaohui Liu (4)
Linxi Huang (5)
Changchun Qu (6)
Lewu Xian (7)
Hao Wu (2)
Yingjie Jiao (3)
Junling Liu (4)
Juyu Cai (5)
Weiying Chen (6)
Zhiqiang Nie (8)
Zaiyi Liu (9)
Chunbo Chen (1)
1. Department of Critical Care Medicine ; Guangdong General Hospital ; Guangdong Academy of Medical Sciences ; 106 Zhongshan Er Road ; Guangzhou ; 510080 ; Guangdong ; PR China
2. Department of Critical Care Medicine ; The First Affiliated Hospital of Guangdong Pharmaceutical University ; 19 Nonglinxia Road ; Guangzhou ; 510080 ; Guangdong ; PR China
3. Department of Critical Care Medicine ; Jiangmen Wuyi Traditional Chinese Medicine Hospital ; 30 Huayuandong Road ; Jiangmen ; 529000 ; Guangdong ; PR China
4. Department of Critical Care Medicine ; Guangdong Armed Police Hospital ; 106 Yanling Road ; Guangzhou ; 510507 ; Guangdong ; PR China
5. Department of Critical Care Medicine ; The First Affiliated Hospital of Shantou University Medical Collage ; 57 Changping Road ; Shantou ; 515041 ; Guangdong ; PR China
6. Department of Critical Care Medicine ; Guangdong Yunfu People鈥檚 Hosipital ; 120 Huanshidong Road ; Yunfu ; 527300 ; Guangdong ; PR China
7. Department of Critical Care Medicine ; Cancer Center of Guangzhou Medical University ; 78 Hengzhigang Road ; Guangzhou ; 510095 ; Guangdong ; PR China
8. Department of Cardiovascular Epidemiology ; Cardiac Surgery ; Guangdong Cardiovascular Institute ; Guangdong General Hospital ; Guangdong Academy of Medical Sciences ; 106 Zhongshan Er Road ; Guangzhou ; 510080 ; Guangdong ; PR China
9. Department of Radiology ; Guangdong General Hospital ; Guangdong Academy of Medical Sciences ; 106 Zhongshan Er Road ; Guangzhou ; 510080 ; Guangdong ; PR China - 刊名：Critical Care
- 出版年：2015
- 出版时间：December 2015
- 年：2015
- 卷：19
- 期：1
- 全文大小：669 KB
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- 出版者：BioMed Central
- ISSN：1364-8535
文摘
Introduction The use of prokinetic agents on post-pyloric placement of spiral nasojejunal tubes is controversial. The aim of the present study was to examine if metoclopramide or domperidone can increase the success rate of post-pyloric placement of spiral nasojejunal tubes. Methods A multicenter, open-label, randomized, controlled trial was conducted in seven hospitals in China between April 2012 and February 2014. Patients admitted to the intensive care unit and requiring enteral nutrition for more than three days were randomly assigned to the metoclopramide, domperidone or control groups (1:1:1 ratio). The primary outcome was defined as the success rate of post-pyloric placement of spiral nasojejunal tubes, assessed 24 hours after initial placement. Secondary outcomes included success rate of post-D1, post-D2, post-D3 and proximal jejunum placement and tube migration distance. Safety of the study drugs and the tubes during the entire study period were recorded. Results In total, 307 patients were allocated to the metoclopramide (n鈥?鈥?03), domperidone (n鈥?鈥?00) or control group (n鈥?鈥?04). The success rate of post-pyloric placement after 24 hours in the metoclopramide, domperidone and control groups was 55.0%, 51.5% and 27.3%, respectively (P鈥?鈥?.0001). Logistic regression analysis identified the use of prokinetic agents, Acute Physiology and Chronic Health Evaluation (APACHE) II score Conclusions Prokinetic agents, such as metoclopramide or domperidone, are effective at improving the success rate of post-pyloric placement of spiral nasojejunal tubes in critically ill patients. Trial registration Chinese Clinical Trial Registry ChiCTR-TRC-12001956. Registered 21 February 2012.