Intravenous XXXX facilitates bedside placement of postpyloric feeding tubes in critically ill adults: a double-blind, randomized, placebo-controlled study.

@entity1 @entity2929
OBJECTIVE To evaluate the efficacy of intravenous @entity2929 as a method to facilitate feeding tube placement into the small intestine in critically ill @entity1 . DESIGN Double blind, randomized, controlled trial. SETTING Medical and surgical intensive care units in an academic medical center. @entity1 Prospective cohort of 36 consecutive adults requiring intensive care unit care and enteral tube feeding for nutritional support. INTERVENTION Infusion of a single dose of intravenous @entity2929 (500 mg) or saline before placement of 10-Fr feeding tubes using a standardized active bedside protocol. MEASUREMENTS AND MAIN RESULTS We determined the success rate of feeding tube placement into or beyond the second portion of the duodenum and the time required for this procedure by experienced nurses. The feeding tube was considered to be postpyloric when the tip was in the second portion of the duodenum or beyond. The predictive value of a serial step-up in gastrointestinal aspirate pH from < or = 5.0 to > or = 6.0 was also determined. Use of intravenous @entity2929 significantly improved the rate of feeding tube placement into the duodenum or jejunum ( @entity2929 group, 13 of 14 @entity1 or 93% vs. the control group, 12 of 22 @entity1 or 55%; p < .03). @entity2929 administration also significantly decreased the procedure time from 25 +/- 3 to 15 +/- 2 mins (p < .04). Feeding tube placement into either duodenum or jejunum was confirmed in all 18 @entity1 with a pH step-up from < or = 5.0 to > or = 6.0. CONCLUSION: A single bolus dose of intravenous @entity2929 facilitates active bedside placement of postpyloric feeding tubes in critically ill adult @entity1 .
