Enteral feeding tube placement success with intravenous metoclopramide administration in ICU patients.

Abstract

OBJECTIVE: The purpose of this study was to determine if intravenous push metoclopramide would facilitate immediate transpyloric passage of a small-bore feeding tube without fluoroscopy or endoscopy. DESIGN: Prospective, randomized trial. PATIENTS: One hundred five medical and surgical ICU patients at a community teaching hospital. INTERVENTIONS: Patients were randomized to receive 10 mg of metoclopramide 10 min before tube insertion or no medication. MEASUREMENT: Successful placement was stated as radiologically verified transduodenal tube location. RESULTS: A 54% success rate was shown with administration of the drug with 46% success for the control. Chi square analysis of the success rate showed no significant relationship between administration of metoclopramide and successful tube placement (p = 0.38). Increasing years of physician training was the only variable associated with successful placement (p = 0.003). No association was found between successful tube placement and presence of endotracheal tube, tracheostomy, or cervical immobility, nor any interaction of metoclopramide with these variables. CONCLUSION: Intravenous metoclopramide, 10 mg, administered 10 min prior to intubation with a small-bore feeding tube (10F), was ineffective in facilitating transpyloric intubation.