Ritz Marc A, Chapman Marianne J, Fraser Robert J, Finnis Mark E, Butler Ross N, Cmielewski Patricia, Davidson Geoffrey P, Rea Deborah
Department of Gastrointestinal Medicine, Royal Adelaide Hospital, 5000, Adelaide, SA, Australia.
Intensive Care Med. 2005 Jul;31(7):949-54. doi: 10.1007/s00134-005-2663-8. Epub 2005 Jun 7.
To compare the effectiveness of 70-mg and 200-mg doses of intravenous erythromycin in improving gastric emptying in critically ill patients.
Gastric emptying was measured on consecutive days; day 1 (pre-treatment), day 2 (post-treatment) after an intravenous infusion of either 70 or 200 mg erythromycin or saline placebo (0.9%), in a randomized double-blind fashion.
Mixed medical/surgical intensive care unit, tertiary referral.
Thirty-five randomly selected, mechanically ventilated, enterally fed critically ill patients (median APACHE II score 19 on admission).
On day 2 either 70 or 200 mg erythromycin or saline was administered intravenously over 20 min.
Gastric emptying was measured using the [13C]octanoic acid breath test. The gastric emptying coefficient (GEC) and half-emptying time (t1/2) were calculated from the area under the 13CO2-recovery curve. Pre-treatment gastric emptying measurements were similar in all three patient groups. Treatment with both doses of erythromycin significantly reduced the gastric t1/2: 70 mg, 98 min (IQR 88-112); 200 mg, 86 min (75-104); vs. placebo, 122 min (102-190) (p<0.05). The GEC was higher with both doses of erythromycin: 70 mg, 3.8 (3.3-4.0); 200 mg, 4.0 (3.6-4.2); vs. placebo, 2.9 (2.5-3.7) (p<0.05). There was no difference in gastric emptying post-treatment between the two doses of erythromycin. The effect of erythromycin was greatest in patients with delayed gastric emptying.
Treatment with 70 and 200 mg intravenous erythromycin are equally effective in accelerating gastric emptying in the critically ill.
比较70毫克和200毫克静脉注射红霉素对改善重症患者胃排空的效果。
连续几天测量胃排空情况；第1天（治疗前），第2天（治疗后），以随机双盲方式静脉输注70毫克或200毫克红霉素或生理盐水安慰剂（0.9%）。
综合内科/外科重症监护病房，三级转诊中心。
35名随机选择的、接受机械通气、肠内喂养的重症患者（入院时急性生理与慢性健康状况评分系统II评分中位数为19）。
在第2天，静脉内20分钟输注70毫克或200毫克红霉素或生理盐水。
使用[13C]辛酸呼气试验测量胃排空。胃排空系数（GEC）和半排空时间（t1/2）根据13CO2回收曲线下的面积计算得出。所有三组患者治疗前的胃排空测量结果相似。两种剂量的红霉素治疗均显著缩短胃t1/2：70毫克组，98分钟（四分位间距88 - 112）；200毫克组，86分钟（75 - 104）；安慰剂组，122分钟（102 - 190）（p<0.05）。两种剂量的红霉素治疗后的GEC均较高：70毫克组，3.8（3.3 - 4.0）；200毫克组，4.0（3.6 - 4.2）；安慰剂组，2.9（2.5 - 3.7）（p<0.05）。两种剂量的红霉素治疗后胃排空无差异。红霉素对胃排空延迟患者的效果最为显著。
70毫克和200毫克静脉注射红霉素在加速重症患者胃排空方面同样有效。
