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Current and future therapeutic prokinetic therapy to improve enteral feed intolerance in the ICU patient.

Authors
  • Fraser, Robert J L1
  • Bryant, Laura
  • 1 Repatriation General Hospital, Daws Road, Daw Park, Adelaide 5041, South Australia. [email protected] , (Australia)
Type
Published Article
Journal
Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
Publication Date
Feb 01, 2010
Volume
25
Issue
1
Pages
26–31
Identifiers
DOI: 10.1177/0884533609357570
PMID: 20130155
Source
Medline
Language
English
License
Unknown

Abstract

Malnutrition is associated with poor outcomes in critically ill patients, and providing enteral feeding to those who cannot eat is considered best practice. Enteral feeding is often unsuccessful when there is delayed gastric emptying. Recent research has given additional insight into the mechanisms underlying delayed gastric emptying. Pharmacological strategies to improve the success of feeding include prokinetic drugs such as metoclopramide and erythromycin alone or in combination. When drug treatment fails, either parenteral nutrition or direct small intestinal feeding is indicated. Simpler methods to access the duodenum and distal small bowel for feed delivery are under investigation. This review summarizes current understanding of the mechanisms underlying enteral feeding intolerance in critical illness, together with the evidence for current treatment practices. Areas requiring further research are also described.

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