Metoclopramide improves gastric motility in critically ill patients
Metoclopramide improves gastric motility in critically ill patients
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DOI：
10.1007/s001340050881
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发表时间：
1999-05-01
影响因子：
38.9
通讯作者：
Collee, G
中科院分区：
文献类型：
--
作者：
Jooste, CA;Mustoe, J;Collee, G
目的：探讨甲氧氯普胺对危重病人胃动力的影响。设计：前瞻性、对照、单盲交叉试验。环境：一个有10个床位的普通重症监护室。患者：10例危重症，肠内喂养无肾功能衰竭的成人患者。干预措施：在连续两天的5小时研究期间，每位患者均通过鼻胃管以50 ml/h的速度肠内喂养rich。在研究开始时按随机顺序静脉注射生理盐水（对照组）或10mg甲氧氯普胺（治疗组）。测量和结果：通过分析在研究开始时将1.5 g扑热息痛与100 ml浓缩饲料一起给予胃的吸收量，间接测量胃动力。胃排空率与血清扑热息痛浓度随时间超过120 min （AUC120）折线图下面积成正比。研究的10名患者中有8名显示，与使用生理盐水相比，使用甲氧氯普胺会增加AUC120。经Wilcoxon符号秩检验统计分析，ap值为0.04，表明甲氧氯普胺给药后胃排空明显增加。结论：静脉注射甲氧氯普胺改善了异质危重患者的胃排空。甲氧氯普胺是一种有效的促动力学药物。
Objective: To assess the effect of metoclopramide on gastric motility in critically ill patients.Design: Prospective, controlled, single-blind cross-over trial.Setting: A 10-bed general intensive care unit.Patients: Ten critically ill, enterally fed adult patients without renal failure.Interventions: Each patient received enteral feeding with Enrich via a nasogastric tube at 50 ml/h throughout the 5-h study period on two consecutive days. Either normal saline (control) or 10 mg of metoclopramide (treatment) was administered intravenously at the start of the study period in random order with cross-over design.Measurements ann results: Gastric motility was measured indirectly by analysis of the absorption over time of 1.5 g of paracetamol administered into the stomach at the start of the study period together with a 100 ml bolus of Enrich feed. The rate of gastric emptying is proportional to the area under the line plot of serum paracetamol concentration against time over 120 min (AUC120). Eight of the ten patients studied showed an increased AUC120 with metoclopramide compared to that with saline. Statistical analysis with the Wilcoxon signed rank test gave ap value of 0.04, indicating a significant increase in gastric emptying following administration of metoclopramide.Conclusions: The administration of Intravenous metoclopramide improved gastric emptying in a heterogeneous group of critically ill patients. Metoclopramide is a useful prokinetic drug in this patient population.