Komenaka I K, Giffard K, Miller J, Schein M
Department of Surgery, New York Methodist Hospital, Brooklyn, and Cornell University Medical College, New York, N.Y., USA.
Dig Surg. 2000;17(6):578-580. doi: 10.1159/000051965.
One of the main difficulties encountered in enteral nutrition in critically ill patients is the impaired gastric emptying: while the small bowel is ready the stomach is still 'lazy'. This paper describes a simple bedside method for postpyloric feeding tube placement, using a gastric prokinetic agent, erythromycin, and patient positioning.
In eight critically ill, burned patients a gastric feeding tube was placed in a reverse Trendelenburg, right lateral decubitus position. A dose of 250 mg of erythromycin was administered intravenously.
In 13 out of 14 attempts, the tube passed into the duodenum, a success rate of 92%.
Combining the prokinetic effects of erythromycin with proper patient positioning allows a rapid bedside transpyloric placement of feeding tubes.
重症患者肠内营养面临的主要困难之一是胃排空受损：当小肠已做好准备时，胃仍然“慵懒”。本文描述了一种简单的床旁幽门后喂养管放置方法，使用促胃动力药物红霉素和患者体位。
对8例重症烧伤患者，在头低脚高右侧卧位放置胃喂养管。静脉注射250mg红霉素。
14次尝试中有13次导管进入十二指肠，成功率为92%。
将红霉素的促动力作用与适当的患者体位相结合，可在床旁快速放置幽门后喂养管。
