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Critical Care
Published in: Critical Care 1/2015

Open Access 01-12-2015 | Research

Metoclopramide or domperidone improves post-pyloric placement of spiral nasojejunal tubes in critically ill patients: a prospective, multicenter, open-label, randomized, controlled clinical trial

Authors: Bei Hu, Heng Ye, Cheng Sun, Yichen Zhang, Zhigang Lao, Fanghong Wu, Zhaohui Liu, Linxi Huang, Changchun Qu, Lewu Xian, Hao Wu, Yingjie Jiao, Junling Liu, Juyu Cai, Weiying Chen, Zhiqiang Nie, Zaiyi Liu, Chunbo Chen

Published in: Critical Care | Issue 1/2015

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Abstract

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 = 103), domperidone (n = 100) or control group (n = 104). 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 = 0.0001). Logistic regression analysis identified the use of prokinetic agents, Acute Physiology and Chronic Health Evaluation (APACHE) II score <20, Sequential Organ Failure Assessment (SOFA) score <12 and without vasopressor as independent factors influencing the success rate of post-pyloric placement. No serious drug-related adverse reaction was observed.

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.
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Metadata
Title
Metoclopramide or domperidone improves post-pyloric placement of spiral nasojejunal tubes in critically ill patients: a prospective, multicenter, open-label, randomized, controlled clinical trial
Authors
Bei Hu
Heng Ye
Cheng Sun
Yichen Zhang
Zhigang Lao
Fanghong Wu
Zhaohui Liu
Linxi Huang
Changchun Qu
Lewu Xian
Hao Wu
Yingjie Jiao
Junling Liu
Juyu Cai
Weiying Chen
Zhiqiang Nie
Zaiyi Liu
Chunbo Chen
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2015
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-015-0784-1

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