Effects of metoclopramide administration on gastric emptying in mechanically ventilated intensive care patients: A prospective randomized controlled trial

Abstract

Background: Vitality of human body is dependent upon proper nutrition. The primary objective of this research is to evaluate metoclopramide impact on gastric emptying in mechanically ventilated individuals. Secondary outcomes include frequency of ventilator-associated pneumonia, hospital stay duration, and weaning time from mechanical ventilation.Methods: Eighty ventilated intensive care head trauma patients of either gender aged 20-40 years were randomly allocated into either metochlopramide or control groups recieving 10mg intravenous metoclopramide or placebo respectively every eight hours for 5 days. We assessed gastric residual volume (GRV) every eight hours for 1st five days of enteral nutrition in semisetting and right lateral positions. Aspiration risk, feeding intolerance, diet volume ratio (DVR), pneumonia incidence, mechanical ventilation duration, and length of ICU & hospital stays were evaluated.Results: GRV was significantly lower in metochlopramide group compared to control group starting from 2nd day till the 5th day (P≤0.05). Aspiration risk significantly reduced in metochlopramide group compared to control group (p<0.05)Enteral nutrition duration and DVR were greater in metoclopramide group compared to control group. (p<0.05).Aspiration pneumonia incidence was 2.5% and 10% in metoclopramide and placebo groups respectively (p>0.05).ICU length of stay and MV duration were significantly lower in metochlopramide group contrasted to control group (p<0.05) without significant difference in hospital stay. Conclusion: Intravenous 10mg metochlopramide every 8hrs for five days resulted in significant reduction of GRV, aspiration risk, FI complications, ICU stay and MV duration and increased DVR without effect on pneumonia incidence or hospital stay.