大黄有助于重症监护病房患者放置鼻空肠喂养管

Nutr Clin Pract. 2016 Feb;31(1):105-10.

Rhubarb to Facilitate Placement of Nasojejunal Feeding Tubes in Patients in the Intensive Care Unit.

Li J, Gu Y, Zhou R.

Department of Intensive Care Unit, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.

BACKGROUND: Prokinetic agents are sometimes needed to aid in the placement of nasojejunal feeding tubes in patients at risk of malnutrition. The objective of the present study was to evaluate the feasibility of rhubarb as a new prokinetic agent to replace metoclopramide and erythromycin in the placement of nasojejunal feeding tubes.

MATERIALS AND METHODS: Ninety-four patients who required jejunal feeding tube insertion were included. They were divided into rhubarb (n = 34), metoclopramide (n = 31), and erythromycin groups (n = 29), depending on the use of rhubarb, metoclopramide, and erythromycin as the prokinetic agent. The jejunal feeding tube insertions were performed at the bedside. An abdominal x-ray was taken as the gold standard to determine the position of the tube. Cases in which insertion failed in either group were subjected to a second insertion attempt using rhubarb as the prokinetic agent.

RESULTS: The success rates in the rhubarb, metoclopramide, and erythromycin groups were 91.2%, 87.1%, and 89.7%, respectively. The difference in the success rates was not statistically significant (P = .916). The insertion times in the rhubarb, metoclopramide, and erythromycin groups were 16.0 ± 1.9 minutes, 18.0 ± 1.9 minutes, and 18.8 ± 2.2 minutes, respectively. The insertion time in the rhubarb group was significantly shorter than those in metoclopramide and erythromycin groups (P < .001). No side effects were noted in the rhubarb group.

CONCLUSIONS: Rhubarb could serve as an effective prokinetic agent to promote the insertion of nasojejunal feeding tubes.

KEYWORDS: critical care; enteral nutrition; enteral tube placement; erythromycin; metoclopramide; nutritional support; rhubarb

PMID: 26459161

DOI: 10.1177/0884533615608363