Promotility drugs use in critical care: Indications and limits?

作者：Libert N^*; De Rudnicki S; Cirodde A; Janvier F; Leclerc T; Borne M; Brinquin L

来源：Annales Francaises d Anesthesie et de Reanimation, 2009, 28(11): 962-975.

DOI：10.1016/j.annfar.2009.08.008

• Gastrointestinal motility
• Critical care
• Prokinetics
• Enteral nutrition
• Erythromycin
• Metoclopramide
• Neostigmine
• Naloxone

Enteral feeding is often limited by gastric and intestinal motility disturbances in critically ill patients, particularly in patients with shock. So, promotility agents are frequently used to improve tolerance to enteral nutrition. This review summaries the pathophysiology, presents the available pharmacological strategies, the clinical data, the counter-indications and the principal limits. The clinical data are poor. No study demonstrates a positive effect on clinical outcomes. Metoclopramide, and erythromycin seems to be the more effective. Considering the risk of antibiotic resistance, the first line use of erythromycin should be avoided in favor of metoclopramide.

• 出版日期2009-11