Critical Illness

CI: Monitoring Criteria: Promotility Agents (2006)

• Intervention
  What is the relationship between the use of promotility agents (e.g., metoclopramide) and enteral feeding tolerance in critically ill patients?

  • Conclusion

    Use of promotility agents (e.g., metoclopramide) or small bowel EN is associated with reduced GRV in critically ill patients.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the relationship between the use of promotility agents (e.g., metoclopramide) and enteral feeding tolerance in critically ill patients?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Boivin MA, Levy H. Gastric feeding with erythromycin is equivalent to transpyloric feeding in the critically ill. Crit Care Med 2001; 39 (10): 1,916-1,919.
      • Booth CM, Heyland DK, Paterson WG. Gastrointestinal promotility drugs in the critical care setting: A systematic review of the evidence. Crit Care Med 2002; 30:1429-1435.
      • Esparza J, Boivin MA, Hartshorne MF, Levy H. Equal aspiration rates in gastrically and transpylorically fed critically ill patients. Intens Care Med 2001; 27: 660-664.
      • Heyland DK, Dhaliwal R, Drover JW, et al. Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients. JPEN. 2003; 27: 355-373.
      • Pinilla JC, Samphire J, Arnold C, et al. Comparison of gastrointestinal tolerance to two enteral feeding protocols in critically ill patients: A prospective, randomized controlled trial. JPEN 2001; 25:81-86.
      • Yavagal DR, Karnad DR, Oak JL. Metoclopramide for preventing pneumonia in critically ill patients receiving enteral tube feeding: A randomized controlled trial. Crit Med 2000;28:1401-1411.
  • Search Plan and Results: CI: Monitoring Criteria in Critical Illness 2003