The metoclopramide effect on enteral nutrition tolerance and mechanical ventilation associated pneumonia in neuro critically ill patients

• Published in: Nutrición hospitalaria : organo oficial de la Sociedad Española de Nutrición Parenteral y Enteral Vol. 29; no. 6; pp. 1345 - 1351
• Main Authors: Acosta-Escribano, Jose, Almanza López, Susana, Plumed Martín, Lidia, García Martinez, Miguel Angel, Tajadura Manjarín, Nuria
• Format: Journal Article
• Language: Spanish
• Published: Spain 01-06-2014
• Subjects: Adult; Aged; Antiemetics - therapeutic use; Critical Illness; Enteral Nutrition - adverse effects; Enteral Nutrition - methods; Female; Gastrointestinal Diseases - etiology; Gastrointestinal Diseases - prevention & control; Humans; Male; Metoclopramide - therapeutic use; Middle Aged; Nervous System Diseases - therapy; Pneumonia, Ventilator-Associated - prevention & control; Prospective Studies; Treatment Outcome
• ISSN: 1699-5198
• DOI: 10.3305/nh.2014.29.6.7286

The use of procinéticos in the critical patient with nutrition enteral, they have as aim reduce the increase of the gastric residue (RG). We evaluate his efficiency in the improvement of the intake enteral and on the reduction in the incident gastrointestinal complications (CGI) and pneumonia, in critical patients, with neurological injury Aims: To evaluate the effects in the administration metoclopramide (MCG), during the first five days with enteral nutrition, versus control (GC), on the volume of administered diet, gastrointestinal complications and the incidence of mechanical ventilation associated pneumonia (NAVM), in neuro-critically patients (NC) of traumatic and vascular aetiology. Prospective, closed-label, randomized study performed in an intensive Care Unit. Methords: 150 adult neuro-critical patients (NC) were admitted of consecutive form and 109 were randomly and two groups 58 MCG y 51 GC. The primary outcomes was the nutritional: the volume of administered diet (VAD); mean efficacious volume (MEV) measured in three consecutive periods of time; the gastrointestinal complications (GIC), and the rate of partial and definitive suspension of the diet. Infecction: incidence of ventilator associated pneumonia NAVM; and of secondary outcomes were: the duration of mechanical ventilation, length of ICU and hospital stay, and incidence the serious sequelae, and 30 days mortality.
Differences were not observed in the severity variables between groups on admission. A significant increase was observed in the global values and in the first five days of (p < 0.03) of the VEM in the group of MCG. The values of the global VDA and during three phases of study, the number CGI, the rate of partial and definitive suspensions of the diet, and number of NAVM, were similar in both not significant groups. Neither differences were observed in the overall analysis secondary variables.
The metoclopramida in the NC, it is not effective in the decrease of the CGI, in the doses and time of treatment reflected in the study.