Prokinetic agents in critical care 英文参考文献.docVIP

Critical Care June 2003 Vol 7 No 3 Doherty and Winter Commentary Prokinetic agents in critical care Warren L Doherty1 and Bob Winter2 1Fellow, Adult Intensive Care Unit, University Hospital, Queen’s Medical Centre, Nottingham, UK 2Consultant, Adult Intensive Care Unit, University Hospital, Queen’s Medical Centre, Nottingham, UK Correspondence: Warren L Doherty, wdoherty@ Published online: 10 January 2003 Critical Care 2003, 7:206-208 (DOI 10.1186/cc1849) This article is online at /content/7/3/206 ? 2003 BioMed Central Ltd (Print ISSN 1364-8535; Online ISSN 1466-609X) Abstract Prokinetic agents are commonly used in intensive care, mainly to aid in early enteral feeding. The present commentary reviews some of the recently published papers and highlights the lack of a sizable evidence base, as well as the possible importance of euglycaemia in this important clinical area. Keywords enteral feeding, erythromycin, hyperglycaemia, intensive care, metolopramide, prokinetic agent Early enteral feeding is now recognized as one of the fundamentals of critical care practice [1–4]. Enteral nutrition (EN) increases gut blood flow, thereby protecting the gastric mucosa [5,6]. Early feeding results in fewer septic complications, decreased catabolic response to injury, decreased stress ulceration in the ventilated patient, improved gut immune function and improved wound healing [3,4,7,8]. Successful enteral feeding relies on intact gastrointestinal motility, which is frequently impaired in the critically ill. remainder looked at the effects of cisapride, erythromycin and metoclopramide on gut transit/feeding tolerance. (For a summary of the actions of those agents, see Table 1.) Cisapride is currently unavailable in many countries because of cardiac toxicity [11]. A breakdown of the reviewed studies is shown in Table 2. If we exclude the studies on tube placement, those with end- points that involved patient outcomes and those gastrointestina