Metoclopramide for preventing pneumonia in critically ill patients receiving enteral tube feeding

A randomized controlled trial

Dileep R Yavagal, Dilip R. Karnad, Jyotsna L. Oak

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

Objective: To determine whether metoclopramide prevents nosocomial pneumonia in intensive care unit (ICU) patients receiving enteral feeding by a nasogastric tube. Design: Prospective, randomized, controlled trial. Setting: ICU of a university hospital. Patients: A total of 305 consecutive patients requiring placement of a nasogastric tube for >24 hrs. Interventions: Patients were randomized to receive either 10 mg of metoclopramide or placebo at 8-hr intervals through the nasogastric tube. Measurements and Main Results: A total of 174 patients received placebo and 131 received metoclopramide. Baseline characteristics in the two treatment groups were comparable. Of the 305 patients, 46 developed nosocomial pneumonia, which was 24 patients (13.7%) in the placebo group and 22 (16.8%) in the metoclopramide group (p > .05). Patients in the placebo group developed pneumonia earlier than patients receiving metoclopramide (4.46 ± 1.72 days [mean ± SD[rsqb] after ICU admission compared with 5.95 ± 1.78 days; p = .006). Subgroup analysis showed that metoclopramide did not reduce the frequency rats of pneumonia in patients with tracheal intubation (19 [25.3%] of 75 patients receiving metoclopramide vs. 21 [21.2%] of 99 patients receiving placebo) or those receiving mechanical ventilation (17 [25.6%] of 58 patients receiving metoclopramide vs. 20 [29.3%] of 78 patients receiving placebo). The mortality rate also did not differ in the two treatments groups (56% in the metoclopramide group vs. 53% in the placebo group; p > .05). Conclusions: Although metoclopramide delayed the development of nosocomial pneumonia, it did not decrease its frequency rate and had no effect on the mortality rate in critically ill patients receiving nasogastric enteral feeding.

Original languageEnglish
Pages (from-to)1408-1411
Number of pages4
JournalCritical Care Medicine
Volume28
Issue number5
StatePublished - Jun 9 2000
Externally publishedYes

Fingerprint

Metoclopramide
Enteral Nutrition
Critical Illness
Pneumonia
Randomized Controlled Trials
Placebos
Intensive Care Units
Mortality
Artificial Respiration
Intubation

Keywords

  • Aspiration
  • Enteral alimentation
  • Gastric motility
  • Gastroesophageal reflux
  • Intensive care unit
  • Nasogastric tube
  • Nosocomial infection
  • Receiving mechanical ventilation
  • Tracheal intubation

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Metoclopramide for preventing pneumonia in critically ill patients receiving enteral tube feeding : A randomized controlled trial. / Yavagal, Dileep R; Karnad, Dilip R.; Oak, Jyotsna L.

In: Critical Care Medicine, Vol. 28, No. 5, 09.06.2000, p. 1408-1411.

Research output: Contribution to journalArticle

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abstract = "Objective: To determine whether metoclopramide prevents nosocomial pneumonia in intensive care unit (ICU) patients receiving enteral feeding by a nasogastric tube. Design: Prospective, randomized, controlled trial. Setting: ICU of a university hospital. Patients: A total of 305 consecutive patients requiring placement of a nasogastric tube for >24 hrs. Interventions: Patients were randomized to receive either 10 mg of metoclopramide or placebo at 8-hr intervals through the nasogastric tube. Measurements and Main Results: A total of 174 patients received placebo and 131 received metoclopramide. Baseline characteristics in the two treatment groups were comparable. Of the 305 patients, 46 developed nosocomial pneumonia, which was 24 patients (13.7{\%}) in the placebo group and 22 (16.8{\%}) in the metoclopramide group (p > .05). Patients in the placebo group developed pneumonia earlier than patients receiving metoclopramide (4.46 ± 1.72 days [mean ± SD[rsqb] after ICU admission compared with 5.95 ± 1.78 days; p = .006). Subgroup analysis showed that metoclopramide did not reduce the frequency rats of pneumonia in patients with tracheal intubation (19 [25.3{\%}] of 75 patients receiving metoclopramide vs. 21 [21.2{\%}] of 99 patients receiving placebo) or those receiving mechanical ventilation (17 [25.6{\%}] of 58 patients receiving metoclopramide vs. 20 [29.3{\%}] of 78 patients receiving placebo). The mortality rate also did not differ in the two treatments groups (56{\%} in the metoclopramide group vs. 53{\%} in the placebo group; p > .05). Conclusions: Although metoclopramide delayed the development of nosocomial pneumonia, it did not decrease its frequency rate and had no effect on the mortality rate in critically ill patients receiving nasogastric enteral feeding.",
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AU - Karnad, Dilip R.

AU - Oak, Jyotsna L.

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N2 - Objective: To determine whether metoclopramide prevents nosocomial pneumonia in intensive care unit (ICU) patients receiving enteral feeding by a nasogastric tube. Design: Prospective, randomized, controlled trial. Setting: ICU of a university hospital. Patients: A total of 305 consecutive patients requiring placement of a nasogastric tube for >24 hrs. Interventions: Patients were randomized to receive either 10 mg of metoclopramide or placebo at 8-hr intervals through the nasogastric tube. Measurements and Main Results: A total of 174 patients received placebo and 131 received metoclopramide. Baseline characteristics in the two treatment groups were comparable. Of the 305 patients, 46 developed nosocomial pneumonia, which was 24 patients (13.7%) in the placebo group and 22 (16.8%) in the metoclopramide group (p > .05). Patients in the placebo group developed pneumonia earlier than patients receiving metoclopramide (4.46 ± 1.72 days [mean ± SD[rsqb] after ICU admission compared with 5.95 ± 1.78 days; p = .006). Subgroup analysis showed that metoclopramide did not reduce the frequency rats of pneumonia in patients with tracheal intubation (19 [25.3%] of 75 patients receiving metoclopramide vs. 21 [21.2%] of 99 patients receiving placebo) or those receiving mechanical ventilation (17 [25.6%] of 58 patients receiving metoclopramide vs. 20 [29.3%] of 78 patients receiving placebo). The mortality rate also did not differ in the two treatments groups (56% in the metoclopramide group vs. 53% in the placebo group; p > .05). Conclusions: Although metoclopramide delayed the development of nosocomial pneumonia, it did not decrease its frequency rate and had no effect on the mortality rate in critically ill patients receiving nasogastric enteral feeding.

AB - Objective: To determine whether metoclopramide prevents nosocomial pneumonia in intensive care unit (ICU) patients receiving enteral feeding by a nasogastric tube. Design: Prospective, randomized, controlled trial. Setting: ICU of a university hospital. Patients: A total of 305 consecutive patients requiring placement of a nasogastric tube for >24 hrs. Interventions: Patients were randomized to receive either 10 mg of metoclopramide or placebo at 8-hr intervals through the nasogastric tube. Measurements and Main Results: A total of 174 patients received placebo and 131 received metoclopramide. Baseline characteristics in the two treatment groups were comparable. Of the 305 patients, 46 developed nosocomial pneumonia, which was 24 patients (13.7%) in the placebo group and 22 (16.8%) in the metoclopramide group (p > .05). Patients in the placebo group developed pneumonia earlier than patients receiving metoclopramide (4.46 ± 1.72 days [mean ± SD[rsqb] after ICU admission compared with 5.95 ± 1.78 days; p = .006). Subgroup analysis showed that metoclopramide did not reduce the frequency rats of pneumonia in patients with tracheal intubation (19 [25.3%] of 75 patients receiving metoclopramide vs. 21 [21.2%] of 99 patients receiving placebo) or those receiving mechanical ventilation (17 [25.6%] of 58 patients receiving metoclopramide vs. 20 [29.3%] of 78 patients receiving placebo). The mortality rate also did not differ in the two treatments groups (56% in the metoclopramide group vs. 53% in the placebo group; p > .05). Conclusions: Although metoclopramide delayed the development of nosocomial pneumonia, it did not decrease its frequency rate and had no effect on the mortality rate in critically ill patients receiving nasogastric enteral feeding.

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KW - Gastric motility

KW - Gastroesophageal reflux

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KW - Nasogastric tube

KW - Nosocomial infection

KW - Receiving mechanical ventilation

KW - Tracheal intubation

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