Naslov
Metoclopramide improves gastric emptying in cardiac surgery patients with early postoperative gastric supply of nutrients
(Metoclopramide improves gastric emptying in cardiac surgery patients with early postoperative gastric supply of nutrients postoperative gastric supply of nutrients)

Autori
Šustić, Alan ; Zelić, Marko ; Sokolić, Jadranko ; Šimić, Ognjen

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Mjesto i datum
,

Vrsta sudjelovanja
Poster

Vrsta recenzije
Nije recenziran

Ključne riječi
Metoclopramide; gastric emptying

Sažetak
INTRODUCTION: Early postoperative intragastric enteral feeding in cardiac surgery patients is frequently complicated by delay gastric emptying and subsequent intolerance of enteral formula. Metoclopramide, safe and inexpensive drug, has previously been shown to significantly accelerate gastric emptying in mechanically ventilated, critically ill patients with intolerance to gastric enteral nutrition 1. The aim of this study was to evaluate the effect of intravenous metoclopramide on gastric emptying in coronary artery by-pass graft (CABG) surgery patients with early postoperative gastric supply of nutrients. METHODS: In the prospective, randomized, placebo-controlled, double-blind study 40 patients treated at cardiosurgical ICU after CABG surgery were studied. The patients were divided in two groups: metoclopramide group M (20 patients: age 60&#61617; 9 yr. ; male 85%) and control group C (20 patients: age 59&#61617; 8 yr. ; male 70%), respectively. The duration of surgery, anesthesia and cardiopulmonary by-pass, the NYHA score, age and sex were not statistically different between groups. In the both groups postoperative gastric supply of standard isoosmotic enteral formula begun 18 hours after surgery (Fresubin, Fresenius Kabi ; 30/50 ml/h ; total 240 ml) by two-lumen nasogastric tube and paracetamol absorption test was used to evaluate gastric emptying. After 6 hours, the gastric supply with nutrients was stopped, paracetamol solution (1000 mg) was administrated by gastric tube and the patients received concurrently 10 mg of metoclopramide i.v. or 2 ml of saline i.v., regarding of the group in which they where randomized. Venous blood samples were obtained from an indwelling peripheral cannula immediately before (t0) and at 15 (t+15), 30 (t+30), 60 (t+60) and 120 (t+120) min after administration of paracetamol. Paracetamol absorption was assessed from the plasma paracetamol concentration (PPC) and the area under the paracetamol concentration curve from 0 to 120 min (AUC). RESULTS: The values of PPC immediately before the administration of metoclopramide or saline (t0) was not significantly different between the groups: group M 2.8&#61617; 0.9 vs. group C 2.4&#61617; 1.8 (p = NS). The PPC values at 15, 30, 60 and 120 min were significantly higher in protocol group M vs. control group C: (t+15) 5.4&#61617; 2.7 vs. 3.3&#61617; 2.5 (p <0.05) ; (t+30) 6.7&#61617; 2.4 vs. 3.7&#61617; 2.0 (p< 0.001) ; (t+60) 7.7&#61617; 2.5 vs. 5.1&#61617; 3.2 (p < 0.01) ; (t+120) 8.5&#61617; 2.2 vs. 5.2&#61617; 2.8 (p <0.01). The AUC value was 34% larger in the M group than in patients from C group. CONCLUSION: In CABG surgery patients with early postoperative gastric supply of nutrients, a single dose of intravenous metoclopramide effective improves gastric emptying.

Izvorni jezik
Engleski

Znanstvena područja
Farmacija

POVEZANOST RADA